Provider Demographics
NPI:1275587222
Name:JEFFERSON CARDIOLOGY ASSOCATION
Entity Type:Organization
Organization Name:JEFFERSON CARDIOLOGY ASSOCATION
Other - Org Name:GREATER PITTSBURGH VASCULAR ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT JEFFERSON CARDIOLOGY ASSN
Authorized Official - Prefix:DR
Authorized Official - First Name:GENNADY
Authorized Official - Middle Name:
Authorized Official - Last Name:GESKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-469-1500
Mailing Address - Street 1:PO BOX 18285
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236
Mailing Address - Country:US
Mailing Address - Phone:412-469-1500
Mailing Address - Fax:412-469-1531
Practice Address - Street 1:1633 ROUTE 51 STE 103
Practice Address - Street 2:
Practice Address - City:JEFFERSON HILLS
Practice Address - State:PA
Practice Address - Zip Code:15025-3652
Practice Address - Country:US
Practice Address - Phone:412-469-1500
Practice Address - Fax:412-469-1531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006711210001Medicaid
JE143968Medicare ID - Type Unspecified
PA0006711210001Medicaid