Organization
BLAIR MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L. BRYAN (PROJECTS MGR.)
(814) 949-7621
Entity
Organization
Contact information
Practice address
620 HOWARD AVE, OP-4, ALTOONA, PA 16601-4804
(814) 889-2708
(814) 889-7926
Mailing address
1414 9TH AVE, STATION MEDICAL CENTER, ALTOONA, PA 16602-2415
(814) 946-1655
(814) 949-7616
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
028095
HIGHMARK GROUP
PA
05
—
1007393100018
—
PA
05
—
1007393100022
—
PA
05
—
1007393100101
—
PA
01
—
1015575
GATEWAY ONCOLOGY
PA
Enumeration date
02/14/2007
Last updated
08/08/2007
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