1740231091 NPI number — GEORGE R CHERIAN M.D., P.C.

Table of content: GEORGE R CHERIAN M.D., P.C. (NPI 1740231091)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740231091 NPI number — GEORGE R CHERIAN M.D., P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHERIAN
Provider First Name:
GEORGE
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D., P.C.
Provider Gender Code:
M

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:
1740231091
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/05/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
803 W MAHONING ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PUNXSUTAWNEY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15767-1309
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-938-0123
Provider Business Mailing Address Fax Number:
814-938-2344

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
803 W MAHONING ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PUNXSUTAWNEY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15767-1309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-938-0123
Provider Business Practice Location Address Fax Number:
814-938-2344
Provider Enumeration Date:
05/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  MD037172L , 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: 1023911 . This is a "GATEWAY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0006183300001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 75865 . This is a "UNISON HEALTH CARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 010016533 . This is a "PALMETTO GBA - RAILROAD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 200688 . This is a "UPMC HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 01327036 . This is a "PA BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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