1366429300 NPI number — VINCENT F. PETRAGLIA AND ASSOCIATES P.C.

Table of content: (NPI 1366429300)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366429300 NPI number — VINCENT F. PETRAGLIA AND ASSOCIATES P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VINCENT F. PETRAGLIA AND ASSOCIATES P.C.
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:
1366429300
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:
455 VALLEYBROOK RD
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
MC MURRAY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15317-3367
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-941-5588
Provider Business Mailing Address Fax Number:
724-941-1458

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
455 VALLEYBROOK RD
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
MC MURRAY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15317-3367
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-941-5588
Provider Business Practice Location Address Fax Number:
724-941-1458
Provider Enumeration Date:
12/30/2005

Additional Information

Authorized Official

Authorized Official Last Name:
PETRAGLIA
Authorized Official First Name:
VINCENT
Authorized Official Middle Name:
F
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
724-941-5588

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1003098 . This is a "GATEWAY GRP NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 842B . This is a "UPMC GRP NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0245789 . This is a "CIGNA GRP#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 4203149 . This is a "AETNA GRP NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 49467 . This is a "UMWA GRP NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 71784 . This is a "THREE RIVERS/MEDPLUS GRP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com