Doctor Name: | FRANK GARY ROMASCAVAGE |
NPI Number: | 1164535423 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DO |
License Number: | OS004898L |
Business Practice Address: | Route 209 Brodheadsville, PA - 18322 |
Business Phone Number: | 5709925500 |
Business Fax Number: | |
Mailing Address: | Po Box 40, Route 209 BRODHEADSVILLE |
State: | PA |
Postal Code: | 18322 |
Phone Number: | 5709925500 |
Fax Number: | |
NPI Enumeration Date: | 08/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | OS004898L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |