National Provider Identifier Database

EXTENDED CARE PHYSICIANS MOUNTAIN PA
Geriatric Medicine

An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.


Contact Information

NPI Profile & details for EXTENDED CARE PHYSICIANS - MOUNTAIN, PA

NPI Number 1104823087
Legal business name
LBN
EXTENDED CARE PHYSICIANS - MOUNTAIN, PA
Authorized official ROBIN GLEESON-WARREN - (CREDENTIALING DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 07/07/2005
Last updated 04/16/2015 - About 11 years ago
Sole proprietor1 Not specified
Identifiers
  • NC License #: 200201376
  • NC License #: 86999
  • NC Medicaid: 89011JK
  • NC Other: 011JK BCBSNC
  • NC Other: 56162 MEDCOST
  • NC Other: CG9205 RAILROAD MEDICARE

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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