Geriatric Research & Consulting Group LLC

Organization Active NPI Geriatric Medicine (Family Medicine) Physician · Bear Creek Township, PA

NPI 1003074600 · NPPES record last updated Jul 10, 2008

Key facts

NPI
1003074600
Entity type
Organization (NPI type 2)
Primary specialty
Geriatric Medicine (Family Medicine) Physician 207QG0300X
License
OS005253L (PA)
Legal business name
GERIATRIC RESEARCH & CONSULTING GROUP LLC
Practice address
1200 Aleeda Blvd
Bear Creek Township, PA 18702-9611
Phone
(570) 829-1095
NPI assigned
May 30, 2008
Organization subpart
No

Authorized official

Name
Mario Cornacchione, D.O
Title
Owner
Phone
(570) 829-1095

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207QG0300X OS005253L PA Yes

Addresses

Primary practice location

1200 Aleeda Blvd
Bear Creek Township, PA 18702-9611

Mailing address

1200 Aleeda Blvd
Bear Creek Township, PA 18702-9611
Phone (570) 829-1095

Other identifiers

IdentifierTypeStateIssuer
OS005253OtherPAMEDICAL LICENSE

Other names

  • Northeast Pennsylvania Memory and Alzheimers Center Other name

Other providers in Bear Creek Township, PA

All providers in Bear Creek Township, PA · Geriatric Medicine (Family Medicine) Physician in Pennsylvania

Sources for this page

Verify at the official NPI Registry.