Provider Demographics
NPI:1417912502
Name:EMERGENCY CARE CONSULTANTS PC
Entity Type:Organization
Organization Name:EMERGENCY CARE CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SERGO
Authorized Official - Middle Name:
Authorized Official - Last Name:SEGARRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-983-1355
Mailing Address - Street 1:19 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-3342
Mailing Address - Country:US
Mailing Address - Phone:724-983-1355
Mailing Address - Fax:724-981-1605
Practice Address - Street 1:19 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146-3342
Practice Address - Country:US
Practice Address - Phone:724-983-1355
Practice Address - Fax:724-981-1605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-20
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012788130005Medicaid
CA2362OtherRR MEDICARE
PA679880OtherHIGHMARK BS
PA679880Medicare ID - Type Unspecified