Provider Demographics
NPI:1174502199
Name:OSCAR Y PICZON & FERDINAND J MAHAHAN
Entity Type:Organization
Organization Name:OSCAR Y PICZON & FERDINAND J MAHAHAN
Other - Org Name:PICZON-MANAHAN ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:Y
Authorized Official - Last Name:PICZON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-346-6170
Mailing Address - Street 1:239 PENN AVE
Mailing Address - Street 2:FORUM PLAZA
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18503
Mailing Address - Country:US
Mailing Address - Phone:570-346-6170
Mailing Address - Fax:570-346-2575
Practice Address - Street 1:239 PENN AVE
Practice Address - Street 2:FORUM PLAZA
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503
Practice Address - Country:US
Practice Address - Phone:570-346-6170
Practice Address - Fax:570-346-2575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-10
Last Update Date:2010-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000153941OtherBLUE SHIELD GROUP
505690OtherAETNA PICZON
PA000036549OtherBLUE SHIELD PICZON
PA220356OtherFIRST PRIORITY GROUP
PA440398OtherFIRST PRIORITY PICZON
PA38078OtherGEISINGER HEALTH MANAHAN
PA000424228OtherBLUE SHIELD MANAHAN
PA440302OtherFIRST PRIORITY MANAHAN
PA0669043OtherPICZON
PA268DOtherGEISINGER HEALTH GROUP
505726OtherAETNA GROUP
PA0669043OtherMANAHAN
PA19816OtherGEISINGER HEALTH PICZON
505518OtherAETNA MANAHAN
PA268DOtherGEISINGER HEALTH GROUP
505518OtherAETNA MANAHAN
PA440398OtherFIRST PRIORITY PICZON
PA0669043OtherPICZON
E52789Medicare UPIN