Provider Demographics
NPI:1417288606
Name:UNIVERSITY CARDIOTHORACIC AND VASCULAR ASSOCIATES, INC
Entity Type:Organization
Organization Name:UNIVERSITY CARDIOTHORACIC AND VASCULAR ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:RICE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-466-3434
Mailing Address - Street 1:100 RADNOR RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-7986
Mailing Address - Country:US
Mailing Address - Phone:814-238-2616
Mailing Address - Fax:814-238-0541
Practice Address - Street 1:100 RADNOR RD
Practice Address - Street 2:SUITE 201
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-7986
Practice Address - Country:US
Practice Address - Phone:814-238-2616
Practice Address - Fax:814-238-0541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-27
Last Update Date:2011-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty