Provider Demographics
NPI:1376687483
Name:CARDIAC ARRHYTHMIA ASSOCIATES OF OHIO INC
Entity Type:Organization
Organization Name:CARDIAC ARRHYTHMIA ASSOCIATES OF OHIO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MITA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHEJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-759-8169
Mailing Address - Street 1:3622 BELMONT AVE
Mailing Address - Street 2:SUITES # 11 & #12
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-1450
Mailing Address - Country:US
Mailing Address - Phone:330-759-8169
Mailing Address - Fax:330-759-8306
Practice Address - Street 1:3622 BELMONT AVE
Practice Address - Street 2:SUITES # 11 & #12
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505-1450
Practice Address - Country:US
Practice Address - Phone:330-759-8169
Practice Address - Fax:330-759-8306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac ElectrophysiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHDO1542OtherRAILROAD MEDICARE
OH0964774Medicaid
F35254Medicare UPIN
SP00941Medicare PIN