Organization
WELLSBORO IMAGING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ENRICO DOGANIERO DO (OWNER)
(570) 723-0163
Entity
Organization
Contact information
Practice address
32-36 CENTRAL AVE, WELLSBORO, PA 16901-1840
(570) 723-0163
Mailing address
PO BOX 21, WELLSBORO, PA 16901-0021
(570) 723-0163
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
170719
HIGHMARK BS
—
01
—
CK4241
TAVELERS MEDICARE
PA
Enumeration date
01/31/2006
Last updated
10/16/2007
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