Provider Demographics
NPI:1073858098
Name:JOHNSTOWN HEART AND VASCULAR CENTER INC.
Entity Type:Organization
Organization Name:JOHNSTOWN HEART AND VASCULAR CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:HADEED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-260-6867
Mailing Address - Street 1:1027 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15906-2437
Mailing Address - Country:US
Mailing Address - Phone:814-619-4587
Mailing Address - Fax:814-254-4154
Practice Address - Street 1:1027 BROAD ST
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15906-2437
Practice Address - Country:US
Practice Address - Phone:814-619-4587
Practice Address - Fax:814-254-4154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-03
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD073567L207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Single Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty