Provider Demographics
NPI:1851168819
Name:JEFFERSON CARDIOLOGY ASSOCATION
Entity Type:Organization
Organization Name:JEFFERSON CARDIOLOGY ASSOCATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:GENNADY
Authorized Official - Middle Name:
Authorized Official - Last Name:GESKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-469-1500
Mailing Address - Street 1:1633 ROUTE 51 STE 103
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3652
Mailing Address - Country:US
Mailing Address - Phone:412-469-1500
Mailing Address - Fax:412-469-1531
Practice Address - Street 1:1633 ROUTE 51 STE 103
Practice Address - Street 2:
Practice Address - City:JEFFERSON HILLS
Practice Address - State:PA
Practice Address - Zip Code:15025-3652
Practice Address - Country:US
Practice Address - Phone:412-469-1500
Practice Address - Fax:412-469-1531
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JEFFERSON CARDIOLOGY ASSOCATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-08
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC3500XNursing Service ProvidersRegistered NurseCardiac RehabilitationGroup - Single Specialty