Provider Demographics
NPI:1891734745
Name:CARDIOVASCULAR CARE, PC
Entity Type:Organization
Organization Name:CARDIOVASCULAR CARE, PC
Other - Org Name:CARDIOVASCULAR CARE II, PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISHNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BHAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-535-3310
Mailing Address - Street 1:321 MAIN ST
Mailing Address - Street 2:SUITE 5H
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15901-1632
Mailing Address - Country:US
Mailing Address - Phone:814-535-3310
Mailing Address - Fax:814-532-6618
Practice Address - Street 1:321 MAIN ST
Practice Address - Street 2:SUITE 5H
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15901-1632
Practice Address - Country:US
Practice Address - Phone:814-535-3310
Practice Address - Fax:814-532-6618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA278768OtherPA BLUE SHIELD
PACI8762OtherPALMETTO GBA
PA011255Medicare PIN