1831120120 NPI number — CARDIOVASCULAR ASSOCIATES, PC

Table of content: NATHAN AMADEO ROYBAL RBT (NPI 1639875412)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831120120 NPI number — CARDIOVASCULAR ASSOCIATES, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARDIOVASCULAR ASSOCIATES, PC
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:
1831120120
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5200 CENTRE AVE
Provider Second Line Business Mailing Address:
SUITE 710
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15232-1300
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-621-5000
Provider Business Mailing Address Fax Number:
412-621-1804

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5200 CENTRE AVE
Provider Second Line Business Practice Location Address:
SUITE 710
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15232-1300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-621-5000
Provider Business Practice Location Address Fax Number:
412-621-1804
Provider Enumeration Date:
07/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WEISS
Authorized Official First Name:
JUDI
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
412-621-5000

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1522719 . This is a "GATEWAY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2053526000 . This is a "INDEPENDENCE BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: CJ8762 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0000000129655 . This is a "UNISON HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 80523 . This is a "MED PLUS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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