Provider Demographics
NPI:1164404653
Name:CARDIOTHORACIC SURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:CARDIOTHORACIC SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING SUPERVISOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:R
Authorized Official - Last Name:DELSARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-359-8186
Mailing Address - Street 1:490 E NORTH AVE
Mailing Address - Street 2:SUITE G105
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4740
Mailing Address - Country:US
Mailing Address - Phone:412-359-8186
Mailing Address - Fax:412-359-8022
Practice Address - Street 1:540 SOUTH ST
Practice Address - Street 2:SUITE 306
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2774
Practice Address - Country:US
Practice Address - Phone:724-837-8959
Practice Address - Fax:724-837-8984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA051652Medicare ID - Type Unspecified