1891768305 NPI number — DR. DONALD LEE AIVALOTIS II D.C.

Table of content: DR. DONALD LEE AIVALOTIS II D.C. (NPI 1891768305)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891768305 NPI number — DR. DONALD LEE AIVALOTIS II D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AIVALOTIS
Provider First Name:
DONALD
Provider Middle Name:
LEE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
II
Provider Credential Text:
D.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:
1891768305
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/30/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
195 DARLENE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORAOPOLIS
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15108-9354
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-498-1422
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7900 STEUBENVILLE PIKE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
IMPERIAL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15126-9139
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-695-3455
Provider Business Practice Location Address Fax Number:
724-695-3456
Provider Enumeration Date:
02/07/2006

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: 111N00000X , with the licence number:  DC007995L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 111N00000X , with the licence number: AJ007995L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 000898673 . This is a "HIGHMARK BCBS NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2979130 . This is a "AETNA HMO NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 410365 . This is a "UPMC NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 7626408 . This is a "AETNA PPO NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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