Provider Demographics
NPI:1598700031
Name:PASSAVANT PROFESSIONAL ASSOCIATES
Entity Type:Organization
Organization Name:PASSAVANT PROFESSIONAL ASSOCIATES
Other - Org Name:DIAGNOSTIC CARDIAC LABORATORY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT, CARDIOVASCULAR SERV
Authorized Official - Prefix:MR
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:K
Authorized Official - Last Name:SAHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-367-6834
Mailing Address - Street 1:9104 BABCOCK BLVD
Mailing Address - Street 2:SUITE 4107
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5818
Mailing Address - Country:US
Mailing Address - Phone:412-367-0100
Mailing Address - Fax:412-357-0165
Practice Address - Street 1:9104 BABCOCK BLVD
Practice Address - Street 2:SUITE 4107
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5818
Practice Address - Country:US
Practice Address - Phone:412-367-0100
Practice Address - Fax:412-357-0165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1249OtherUPMC
PA1488917OtherUNITED MINE WORKERS
PA024400OtherHIGHMARK
PA080465OtherAETNA
PA024400OtherHIGHMARK
PA1249OtherUPMC