| Avella Family Practice,llc | |
|
9 Campbell Dr Box 187 Avella PA 15312-2738 | |
| (724) 587-3472 | |
| (724) 587-5947 |
| Full Name | Avella Family Practice,llc |
|---|---|
| Speciality | Family Medicine |
| Location | 9 Campbell Dr, Avella, Pennsylvania |
| Authorized Official Name and Position | Sean Matthew Porbin (OWNER) |
| Authorized Official Contact | 7245873472 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Avella Family Practice,llc 1394 Avella Rd Avella PA 15312-3302 Ph: (724) 587-0296 | Avella Family Practice,llc 9 Campbell Dr Box 187 Avella PA 15312-2738 Ph: (724) 587-3472 |
| NPI Number | 1659455988 |
|---|---|
| Provider Enumeration Date | 10/24/2006 |
| Last Update Date | 07/15/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659455988 | NPI | - | NPPES |
| 1011626600001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD063186L (Pennsylvania) | Primary |