Provider Demographics
NPI:1467491217
Name:CARDIOLOGY ASSOCIATES OF GREATER HAZLETON PC
Entity Type:Organization
Organization Name:CARDIOLOGY ASSOCIATES OF GREATER HAZLETON PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:CIOTOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-454-2467
Mailing Address - Street 1:141 N VINE ST
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201
Mailing Address - Country:US
Mailing Address - Phone:570-454-2467
Mailing Address - Fax:570-455-2070
Practice Address - Street 1:141 N VINE ST
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201
Practice Address - Country:US
Practice Address - Phone:570-454-2467
Practice Address - Fax:570-455-2070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DB2081OtherRAILROAD MEDICARE
PA02853600OtherCAPITAL BLUE CROSS
PA0007606510002Medicaid
PA006142Medicare PIN