| Blair Regenerative Medicine Llc | |
|
1381 Plank Rd Ste 102 Duncansville PA 16635-8458 | |
| (814) 317-5074 | |
| Not Available |
| Full Name | Blair Regenerative Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1381 Plank Rd Ste 102, Duncansville, Pennsylvania |
| Authorized Official Name and Position | Darryl Keef Warner (OWNER) |
| Authorized Official Contact | 8143175074 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blair Regenerative Medicine Llc 1381 Plank Rd Ste 102 Duncansville PA 16635-8458 Ph: (814) 317-5074 | Blair Regenerative Medicine Llc 1381 Plank Rd Ste 102 Duncansville PA 16635-8458 Ph: (814) 317-5074 |
| NPI Number | 1629624689 |
|---|---|
| Provider Enumeration Date | 08/15/2019 |
| Last Update Date | 08/15/2019 |
| Medicare PECOS PAC ID | 1951733872 |
|---|---|
| Medicare Enrollment ID | O20191114002845 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629624689 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael A Lettieri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285652446 PECOS PAC ID: 4284528704 Enrollment ID: I20040213000242 |
| Provider Name | Maribeth A Mills |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1255402475 PECOS PAC ID: 7315022647 Enrollment ID: I20080311000573 |
| Provider Name | Jose F Derr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942298070 PECOS PAC ID: 6608903612 Enrollment ID: I20100423000124 |
| Provider Name | Robyn F Isgan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1659684744 PECOS PAC ID: 3476746587 Enrollment ID: I20101021000800 |
| Provider Name | Lauren B Wiegman |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1710535232 PECOS PAC ID: 9335573880 Enrollment ID: I20191217000669 |
| Provider Name | Torry Earley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750924189 PECOS PAC ID: 9436576188 Enrollment ID: I20200827000005 |
Blair Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 149 Deville Drive, Duncansville, PA 16635 Phone: 814-693-0628 Fax: 814-693-0637 | |
Burwell Family Medicine, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3 764 Plz, Duncansville, PA 16635 Phone: 814-695-3305 |