Ellenberger, Thomas Richard

Ellenberger, Thomas Richard is an individual health care provider with primary practice located at 321 Main St Suite 5D, Johnstown PA 15901-1632. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Ellenberger, Thomas Richard can be contacted via phone (814) 535-7885.

Contact Information

Primary practice address
321 Main St Suite 5D Johnstown PA 15901-1632
Phone: (814) 535-7885
Fax: (814) 535-7079
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD018414E Pennsylvania

Profile Details

NPI number 1508818410
LBN Legal business name Ellenberger, Thomas Richard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Jul 8th, 2007 - about 18 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 1508818410 NPPES
Pennsylvania MEDICAID 0006378450001
Pennsylvania Other 027796
Pennsylvania Other 0743755
Pennsylvania Other 11978

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