Provider Demographics
NPI:1487643839
Name:SURGICAL ASSOCIATES OF GREENSBURG PC
Entity Type:Organization
Organization Name:SURGICAL ASSOCIATES OF GREENSBURG PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-836-6575
Mailing Address - Street 1:510 PELLIS RD
Mailing Address - Street 2:STE 203
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-4583
Mailing Address - Country:US
Mailing Address - Phone:724-836-6575
Mailing Address - Fax:724-836-6654
Practice Address - Street 1:510 PELLIS RD
Practice Address - Street 2:STE 203
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-4583
Practice Address - Country:US
Practice Address - Phone:724-836-6575
Practice Address - Fax:724-836-6654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2353906OtherAETNA/ US HEALTHCARE
PAGE851793Medicare ID - Type Unspecified