| Jay E Endres Mdpc | |
|
12 Elm St Warren PA 16365-2808 | |
| (814) 723-3520 | |
| (814) 726-2988 |
| Full Name | Jay E Endres Mdpc |
|---|---|
| Speciality | Family Medicine |
| Location | 12 Elm St, Warren, Pennsylvania |
| Authorized Official Name and Position | Nancy J Endres (CORPORATE TREASURER) |
| Authorized Official Contact | 8147233520 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jay E Endres Mdpc 12 Elm St Warren PA 16365-2808 Ph: (814) 723-3520 | Jay E Endres Mdpc 12 Elm St Warren PA 16365-2808 Ph: (814) 723-3520 |
| NPI Number | 1780875757 |
|---|---|
| Provider Enumeration Date | 08/06/2007 |
| Last Update Date | 08/06/2007 |
| Medicare PECOS PAC ID | 1052359296 |
|---|---|
| Medicare Enrollment ID | O20050419001043 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780875757 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD039470L (Pennsylvania) | Primary |
| Provider Name | Deborah Cann Bialas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790717551 PECOS PAC ID: 0244272755 Enrollment ID: I20050525000405 |
| Provider Name | Jay E Endres |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073581948 PECOS PAC ID: 8628086964 Enrollment ID: I20060329000323 |
| Provider Name | Jill M Gorton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255531489 PECOS PAC ID: 1951494483 Enrollment ID: I20070829000633 |
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