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
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