Organization · NPI-2
Heritage Medical Group, LLP
Family Medicine · Enola, PA
NPI number1760636815
StatusActive
Last updated in NPPESMay 29, 2009
Details
- NPI
- 1760636815
- Entity type
- Organization (NPI-2)
- Legal business name
- Heritage Medical Group, LLP
- Organization subpart
- No
- Enumeration date
- Nov 14, 2008
- Last updated
- May 29, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
| 363L00000X | Nurse Practitioner | – | – |
Other names
- Cumberland Family Practice (Doing Business As)
Practice location
4470 Valley RdEnola, PA 17025-1443
Phone 717-732-8883 · Fax 717-732-1640
Mailing address
3 Walnut StSuite 206
Lemoyne, PA 17043-1168
Phone 717-761-0208 · Fax 717-761-2023
Authorized official
Joseph A. Cincotta
Medical Director
7177610208
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