Provider Demographics
NPI:1487851192
Name:INTERNAL MEDICINE ASSOCIATES OF NORTHWESTERN PA PC
Entity Type:Organization
Organization Name:INTERNAL MEDICINE ASSOCIATES OF NORTHWESTERN PA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DILIP
Authorized Official - Middle Name:K
Authorized Official - Last Name:JANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-456-6258
Mailing Address - Street 1:2931 PEACH STR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-1842
Mailing Address - Country:US
Mailing Address - Phone:814-456-6258
Mailing Address - Fax:814-456-6258
Practice Address - Street 1:2931 PEACH STR
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-1842
Practice Address - Country:US
Practice Address - Phone:814-456-6258
Practice Address - Fax:814-456-6258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD018905E207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA016696Medicare UPIN