Provider Demographics
NPI:1396831137
Name:CARDIOVASCULAR ASSOC
Entity Type:Organization
Organization Name:CARDIOVASCULAR ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANGER
Authorized Official - Prefix:
Authorized Official - First Name:JUDI
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-561-6000
Mailing Address - Street 1:1 PENN CTR W
Mailing Address - Street 2:STE 307
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15276-0109
Mailing Address - Country:US
Mailing Address - Phone:412-788-4995
Mailing Address - Fax:412-788-0250
Practice Address - Street 1:5200 CENTRE AVE
Practice Address - Street 2:STE 710
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1300
Practice Address - Country:US
Practice Address - Phone:412-561-6000
Practice Address - Fax:412-621-1804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019067790001Medicaid
PA0019067790001Medicaid