Organization
TRI-STATE MEDICAL GROUP, INC
Active
Parent organization
TRI-STATE MEDICAL GROUP, INC
Other names
TSMG Book, Burk, and Incorvati Surgical Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRI-STATE MEDICAL GROUP, INC
Authorized official
NORMAN F. MITRY (PRESIDENT & CEO)
(724) 773-4776
Entity
Organization
Contact information
Practice address
1520 3RD AVE, NEW BRIGHTON, PA 15066-2204
(724) 843-3800
Mailing address
1520 3RD AVE, NEW BRIGHTON, PA 15066-2204
(724) 843-3800
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015654460023
—
PA
05
—
0202677
—
OH
Enumeration date
10/10/2008
Last updated
10/10/2008
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