Provider Demographics
NPI:1073630190
Name:WADHWANI CARDIO PULUMONARY ASSOCIATES, INC
Entity Type:Organization
Organization Name:WADHWANI CARDIO PULUMONARY ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BHAGWAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:WADHWANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-785-2330
Mailing Address - Street 1:129 SIMPSON RAOD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:BROWNSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15417
Mailing Address - Country:US
Mailing Address - Phone:724-785-2330
Mailing Address - Fax:
Practice Address - Street 1:129 SIMPSON RAOD
Practice Address - Street 2:SUITE 102
Practice Address - City:BROWNSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15417
Practice Address - Country:US
Practice Address - Phone:724-785-2330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD030604L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD030604LOtherLICENSE
PA018637Medicare PIN
PAMD030604LOtherLICENSE