Provider Demographics
NPI:1164403101
Name:GASTROENTEROLOGY ASSOCIATES, INC.
Entity Type:Organization
Organization Name:GASTROENTEROLOGY ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:FASCETTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-621-7777
Mailing Address - Street 1:5200 CENTRE AVE
Mailing Address - Street 2:SUITE 312
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1300
Mailing Address - Country:US
Mailing Address - Phone:412-621-7777
Mailing Address - Fax:412-683-8698
Practice Address - Street 1:5200 CENTRE AVE
Practice Address - Street 2:SUITE 312
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1300
Practice Address - Country:US
Practice Address - Phone:412-621-7777
Practice Address - Fax:412-683-8698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008880950012Medicaid
PA0008880950012Medicaid