Provider Demographics
NPI:1427077676
Name:TELEMARK PHYSICAL MEDICINE, P.C.
Entity type:Organization
Organization Name:TELEMARK PHYSICAL MEDICINE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:A
Authorized Official - Last Name:VALENTINE
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN
Authorized Official - Phone:724-588-8884
Mailing Address - Street 1:10 GREENVILLE PLZ
Mailing Address - Street 2:HADLEY ROAD
Mailing Address - City:GREENVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16125-1240
Mailing Address - Country:US
Mailing Address - Phone:724-588-8884
Mailing Address - Fax:724-588-8931
Practice Address - Street 1:10 GREENVILLE PLZ
Practice Address - Street 2:HADLEY ROAD
Practice Address - City:GREENVILLE
Practice Address - State:PA
Practice Address - Zip Code:16125-1240
Practice Address - Country:US
Practice Address - Phone:724-588-8884
Practice Address - Fax:724-588-8931
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015351510005Medicaid
PA0015351510005Medicaid