1164404653 NPI number — CARDIOTHORACIC SURGICAL ASSOCIATES

Table of content: (NPI 1164404653)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164404653 NPI number — CARDIOTHORACIC SURGICAL ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARDIOTHORACIC SURGICAL ASSOCIATES
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:
1164404653
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
490 E NORTH AVE
Provider Second Line Business Mailing Address:
SUITE G105
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15212-4740
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-359-8186
Provider Business Mailing Address Fax Number:
412-359-8022

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
540 SOUTH ST
Provider Second Line Business Practice Location Address:
SUITE 306
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-2774
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-837-8959
Provider Business Practice Location Address Fax Number:
724-837-8984
Provider Enumeration Date:
11/18/2005

Additional Information

Authorized Official

Authorized Official Last Name:
DELSARDO
Authorized Official First Name:
CRYSTAL
Authorized Official Middle Name:
R
Authorized Official Title or Position:
BILLING SUPERVISOR
Authorized Official Telephone Number:
412-359-8186

Provider Taxonomy Codes

  • Taxonomy code: 208G00000X , 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)





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