Organization
TRI STATE GYNECOLOGY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NORMAN F MITRY (PRESIDENT AND CEO)
(724) 773-4779
Entity
Organization
Contact information
Practice address
690 STATE AVE, BEAVER, PA 15009-9501
(724) 774-4546
(724) 774-9007
Mailing address
2 PEARTREE WAY, BEAVER, PA 15009-1954
(724) 728-4171
(724) 728-2019
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
207VG0400X
Gynecology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010070720001
—
PA
Enumeration date
05/28/2006
Last updated
10/30/2007
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