Provider Demographics
NPI:1558617084
Name:BORNEMANN CARDIOTHORACIC ASSOCIATES
Entity Type:Organization
Organization Name:BORNEMANN CARDIOTHORACIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-208-4667
Mailing Address - Street 1:2494 BERNVILLE RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19605-9469
Mailing Address - Country:US
Mailing Address - Phone:610-378-2676
Mailing Address - Fax:610-378-2679
Practice Address - Street 1:2494 BERNVILLE RD
Practice Address - Street 2:SUITE 207
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19605-9469
Practice Address - Country:US
Practice Address - Phone:610-378-2676
Practice Address - Fax:610-378-2679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-02
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA055582363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty