Organization
PULMONARY AND SLEEP MEDICINE OF CENTRAL PA PC
Active
Organization
PULMONARY AND SLEEP MEDICINE OF CENTRAL PA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELO ILLUZZI DO (PRESIDENT OF CORPORATION)
(814) 375-5305
Entity
Organization
Contact information
Practice address
145 HOSPITAL AVE, STE 101, DUBOIS, PA 15801
(814) 375-5305
(814) 375-5307
Mailing address
145 HOSPITAL AVE, STE 101, DUBOIS, PA 15801
(814) 375-5305
(814) 375-5307
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013140640002
—
PA
01
—
1695
GEISINGER
—
Enumeration date
08/30/2006
Last updated
03/25/2008
Update your record
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