Boccagno, Phillip A

Boccagno, Phillip A is an individual health care provider with primary practice located at 231 Northern Blvd Suite 3, Clarks Summit PA 18411-9189. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Boccagno, Phillip A can be contacted via phone (570) 587-4113.

Contact Information

Primary practice address
231 Northern Blvd Suite 3 Clarks Summit PA 18411-9189
Phone: (570) 587-4113
Fax: (570) 587-7703
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD022568E Pennsylvania

Profile Details

NPI number 1639159510
LBN Legal business name Boccagno, Phillip A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 18th, 2006
Last updated Jan 11th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639159510 NPPES
Pennsylvania MEDICAID 00093540

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