Provider Demographics
NPI:1497740450
Name:UROLOGY CENTER, INC
Entity Type:Organization
Organization Name:UROLOGY CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:M
Authorized Official - Last Name:DALONI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-983-1611
Mailing Address - Street 1:2400 HIGHLAND RD
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-2868
Mailing Address - Country:US
Mailing Address - Phone:724-983-1611
Mailing Address - Fax:724-983-1022
Practice Address - Street 1:2400 HIGHLAND RD
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-2868
Practice Address - Country:US
Practice Address - Phone:724-983-1611
Practice Address - Fax:724-983-1022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-15
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012443970003Medicaid
PA0012443970003Medicaid