Provider Demographics
NPI:1538468368
Name:SENECA CARDIOLOGY
Entity Type:Organization
Organization Name:SENECA CARDIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PARIS
Authorized Official - Middle Name:B
Authorized Official - Last Name:HORAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-677-8999
Mailing Address - Street 1:105 RANCH STREET
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:PA
Mailing Address - Zip Code:16346
Mailing Address - Country:US
Mailing Address - Phone:814-677-8999
Mailing Address - Fax:814-677-8998
Practice Address - Street 1:105 RANCH STREET
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:PA
Practice Address - Zip Code:16346
Practice Address - Country:US
Practice Address - Phone:814-677-8999
Practice Address - Fax:814-677-8998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD052745L207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA90821Medicare UPIN