Provider Demographics
NPI:1306966734
Name:JULIAN C TOLENTINO PC
Entity type:Organization
Organization Name:JULIAN C TOLENTINO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:TOLENTINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-282-1542
Mailing Address - Street 1:316 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-4920
Mailing Address - Country:US
Mailing Address - Phone:724-282-1542
Mailing Address - Fax:724-282-3688
Practice Address - Street 1:316 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-4920
Practice Address - Country:US
Practice Address - Phone:724-282-1542
Practice Address - Fax:724-282-3688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA006468800001Medicaid
PA006468800001Medicaid
PA084165Medicare PIN