Organization
JOSE R. ACOSTA, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY K STAYER (OFFICE MANAGER)
(717) 242-2711
Entity
Organization
Contact information
Practice address
27 SANDY LN, SUITE 140, LEWISTOWN, PA 17044-1310
(717) 242-2711
(717) 248-0502
Mailing address
27 SANDY LN, SUITE 140, LEWISTOWN, PA 17044-1310
(717) 242-2711
(717) 248-0502
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009520150004
—
PA
01
—
02552500
CAPITAL BLUE CROSS
PA
01
—
076706
PENNSYLVANIA BLUE SHIELD
PA
Enumeration date
01/11/2007
Last updated
08/22/2020
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