Provider Demographics
NPI:1598865727
Name:ONCOLOGY HEMATOLOGY ASSOCIATES OF NORTHERN PA, PC
Entity Type:Organization
Organization Name:ONCOLOGY HEMATOLOGY ASSOCIATES OF NORTHERN PA, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARMINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCHIOLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-375-3535
Mailing Address - Street 1:PO BOX 447
Mailing Address - Street 2:100 HOSPITAL AVE
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-0447
Mailing Address - Country:US
Mailing Address - Phone:814-375-3535
Mailing Address - Fax:814-375-3563
Practice Address - Street 1:100 HOSPITAL AVE
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-1440
Practice Address - Country:US
Practice Address - Phone:814-375-3535
Practice Address - Fax:814-375-3563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018758140004Medicaid
PA0018758140004Medicaid