Organization
TRI-STATE PEDIATRIC ASSOCIATES, INC
Active
Parent organization
TRI-STATE PEDIATRIC ASSOCIATES, INC
Other names
TSPEDS Kasi
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRI-STATE PEDIATRIC ASSOCIATES, INC
Authorized official
NORMAN MITRY (PRESIDENT & CEO)
(724) 773-4776
Entity
Organization
Contact information
Practice address
3542 BRODHEAD RD, MONACA, PA 15061-3126
(724) 775-9919
Mailing address
3542 BRODHEAD RD, MONACA, PA 15061-3126
(724) 775-9919
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007289980010
—
PA
05
—
2023643
—
OH
Enumeration date
10/10/2008
Last updated
10/10/2008
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