Provider Demographics
NPI:1275205171
Name:SHADYSIDE CARDIOVASCULAR, PLLC
Entity Type:Organization
Organization Name:SHADYSIDE CARDIOVASCULAR, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-688-6414
Mailing Address - Street 1:1728 BEECHWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-1714
Mailing Address - Country:US
Mailing Address - Phone:412-216-1393
Mailing Address - Fax:
Practice Address - Street 1:5750 CENTRE AVE STE 395
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3729
Practice Address - Country:US
Practice Address - Phone:412-688-6414
Practice Address - Fax:412-945-7220
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty