Provider Demographics
NPI:1568419448
Name:ASSOCIATES IN NEPHROLOGY PC
Entity Type:Organization
Organization Name:ASSOCIATES IN NEPHROLOGY PC
Other - Org Name:THE REGIONAL KIDNEY DISEASE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AGNES
Authorized Official - Middle Name:M
Authorized Official - Last Name:DANOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-453-6687
Mailing Address - Street 1:311 W 24TH ST
Mailing Address - Street 2:SUITE 402
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-2665
Mailing Address - Country:US
Mailing Address - Phone:814-453-6687
Mailing Address - Fax:814-456-4676
Practice Address - Street 1:311 W 24TH ST
Practice Address - Street 2:SUITE 402
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-2665
Practice Address - Country:US
Practice Address - Phone:814-453-6687
Practice Address - Fax:814-456-4676
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2009-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008388340005Medicaid
PA094261OtherHIGHMARK BS
PA0008388340005Medicaid
NYAA1253Medicare ID - Type Unspecified