Provider Demographics
NPI:1154581361
Name:QUALITY CARE INTERNAL MEDICINE
Entity type:Organization
Organization Name:QUALITY CARE INTERNAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:AMBUSKE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:814-363-9540
Mailing Address - Street 1:195 PLEASANT ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BRADFORD
Mailing Address - State:PA
Mailing Address - Zip Code:16701-1081
Mailing Address - Country:US
Mailing Address - Phone:814-363-9540
Mailing Address - Fax:814-363-9562
Practice Address - Street 1:195 PLEASANT ST
Practice Address - Street 2:SUITE 5
Practice Address - City:BRADFORD
Practice Address - State:PA
Practice Address - Zip Code:16701-1081
Practice Address - Country:US
Practice Address - Phone:814-363-9540
Practice Address - Fax:814-363-9562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-11
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS013889207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty