Organization
CENTRAL PA PODIATRY LLC
Active
Parent organization
CENTRAL PA CARDIOLOGY, LLC
Other names
Central PA Physicians Group
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRAL PA CARDIOLOGY, LLC
Authorized official
DENISE BARANIK (PRACTICE MANAGER)
(814) 201-2309
Entity
Organization
Contact information
Practice address
914 S 12TH ST, ALTOONA, PA 16602-6247
(814) 201-2309
(814) 201-2389
Mailing address
914 S 12TH ST, ALTOONA, PA 16602-6247
(814) 201-2309
(814) 201-2389
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1029762890001
—
PA
01
—
1487632428
DR. DONALD MRDJENOVICH
PA
01
—
1902884950
DR. GERALD GRONBORG
PA
Enumeration date
12/30/2020
Last updated
12/30/2020
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