Provider Demographics
NPI:1881639284
Name:REGIONAL ANESTHESIA ASSOCIATES
Entity Type:Organization
Organization Name:REGIONAL ANESTHESIA ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF GROUP
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUCKWALTER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:724-983-3940
Mailing Address - Street 1:PO BOX 1168
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-0168
Mailing Address - Country:US
Mailing Address - Phone:724-983-0840
Mailing Address - Fax:724-983-0841
Practice Address - Street 1:740 E STATE ST
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146-3328
Practice Address - Country:US
Practice Address - Phone:724-983-3940
Practice Address - Fax:724-983-7276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0019024480001Medicaid
PA057066Medicare ID - Type Unspecified