Provider Demographics
NPI:1518954155
Name:LIMCUANDO, EMILIANO L (MD)
Entity Type:Individual
Prefix:
First Name:EMILIANO
Middle Name:L
Last Name:LIMCUANDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:PA
Mailing Address - Zip Code:15501-2239
Mailing Address - Country:US
Mailing Address - Phone:814-445-4181
Mailing Address - Fax:814-445-3993
Practice Address - Street 1:401 S CENTER AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-2239
Practice Address - Country:US
Practice Address - Phone:814-445-4181
Practice Address - Fax:814-445-3993
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD034119L208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA556122OtherAETNA US HEALTH CARE
PALI126301OtherHIGHMARK BC BS
PA0006110430001Medicaid
PA6486OtherHEALTH AMERICA
PA1038093OtherGATEWAY HEALTH PLAN
PA207930OtherUPMC
PA846398ML2OtherMAMSI
PA556122OtherAETNA US HEALTH CARE
PALI126301OtherHIGHMARK BC BS
PA126301Medicare ID - Type UnspecifiedMEDICARE ID #