Organization
JOHN M VASIL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELAINE M LAMBERT (PRESIDENT)
(814) 534-1630
Entity
Organization
Contact information
Practice address
1704 PHILADELPHIA AVE, NORTHERN CAMBRIA, PA 15714-1180
(814) 948-0775
(814) 948-0746
Mailing address
1704 PHILADELPHIA AVE, NORTHERN CAMBRIA, PA 15714-1180
(814) 948-0775
(814) 948-0746
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019147430003
—
PA
01
—
N5J0918249
BLUE SHIELD
PA
Enumeration date
11/01/2007
Last updated
05/04/2011
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