Provider Demographics
NPI:1851385900
Name:CARLTON CARDIOLOGY ASSOCIATES, INC.
Entity Type:Organization
Organization Name:CARLTON CARDIOLOGY ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GANSBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-322-2622
Mailing Address - Street 1:490 E NORTH AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4740
Mailing Address - Country:US
Mailing Address - Phone:412-322-2622
Mailing Address - Fax:412-322-3093
Practice Address - Street 1:490 E NORTH AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4740
Practice Address - Country:US
Practice Address - Phone:412-322-2622
Practice Address - Fax:412-322-3093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-06
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA078243E15OtherMEDICARE
PA0013996680005Medicaid
PA0013996680005Medicaid