National Provider Identifier Database

THOMAS R ELLENBERGER JR MD PC
Medical Specialty

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).


Contact Information

THOMAS R. ELLENBERGER, JR MD PC
321 MAIN ST STE 5D
JOHNSTOWN, PA15901-1632
Phone: 814-535-7885
Fax: 814-535-7079
Website:
Specialty Taxonomy Code
* Medical Specialty 261QM2500X

* Indicates primary specialty

NPI Profile & details for THOMAS R. ELLENBERGER, JR MD PC

NPI Number 1942325592
Legal business name
LBN
THOMAS R. ELLENBERGER, JR MD PC
Authorized official THOMAS ELLENBERGER - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 03/20/2007
Last updated 09/27/2007 - About 19 years ago
Sole proprietor1 Not specified
Identifiers
  • PA License #: MD018414E
  • PA Medicaid: 0006378450001
  • Other: 0743755 UMWA
  • PA Other: 027796 HIGHMARK
  • PA Other: 11978 UPMC HEALTH PLAN

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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