Active NPI
Pandolph & Polansky Family Practice PC
- Family Medicine Physician
- State College, PA
National Provider Identifier
1861455792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- PANDOLPH & POLANSKY FAMILY PRACTICE PC
- Practice address
- 1528 Martin St
State College, PA 16803-3058 - Phone
- (814) 234-2007
- NPI assigned
- Apr 11, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Stephen J Pandolph, MD
- Title
- President
- Phone
- (814) 234-2007
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
1528 Martin St
State College, PA 16803-3058
Mailing address
1528 Martin St
State College, PA 16803-3058
Phone (814) 234-2007
National Provider Directory
National Provider DirectoryLocations
1528 Martin St
State College, PA 16803
Phone (814) 234-2007
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Mount Jackson, VA
- NPI 1649234048
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144713600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658361600000",
"number": "1861455792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1528 MARTIN ST",
"city": "STATE COLLEGE",
"state": "PA",
"postal_code": "168033058",
"telephone_number": "814-234-2007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1528 MARTIN ST",
"city": "STATE COLLEGE",
"state": "PA",
"postal_code": "168033058",
"telephone_number": "814-234-2007"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PANDOLPH & POLANSKY FAMILY PRACTICE PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-11",
"last_updated": "2022-07-21",
"status": "A",
"authorized_official_last_name": "PANDOLPH",
"authorized_official_first_name": "STEPHEN",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "814-234-2007",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in State College, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.