1215140207 NPI number — ADK CARDIOLOGY, INC

Table of content: (NPI 1215140207)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215140207 NPI number — ADK CARDIOLOGY, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADK CARDIOLOGY, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215140207
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/09/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6637 ROUTE 30
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JEANNETTE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15644
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-523-2000
Provider Business Mailing Address Fax Number:
724-527-5940

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6637 ROUTE 30
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JEANNETTE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15644
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-523-2000
Provider Business Practice Location Address Fax Number:
724-572-5940
Provider Enumeration Date:
05/07/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ROBISON
Authorized Official First Name:
GAYLE
Authorized Official Middle Name:
C
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
724-523-2000

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  MD056776L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: P00375954 . This is a "RAILDROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".