Individual
STEPHEN J BISACCO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2918 6TH AVE, ALTOONA, PA 16602-1917
(814) 944-6055
(814) 944-1912
Mailing address
2918 6TH AVE, ALTOONA, PA 16602-1917
(814) 944-6055
(814) 944-1912
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD028089E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008890560001
—
PA
01
—
1020321
GATEWAY
PA
01
—
104311
UPMC
PA
01
—
197314
HIGHMARK
PA
01
—
61954
THREE RIVERS-UNISON
PA
Enumeration date
12/28/2005
Last updated
07/08/2007
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