Provider Demographics
NPI:1134266992
Name:EMILIANO L LIMCUANDO MD PC
Entity type:Organization
Organization Name:EMILIANO L LIMCUANDO MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILIANO
Authorized Official - Middle Name:L
Authorized Official - Last Name:LIMCUANDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-445-4181
Mailing Address - Street 1:401 S CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:PA
Mailing Address - Zip Code:15501-2239
Mailing Address - Country:US
Mailing Address - Phone:814-445-4181
Mailing Address - Fax:814-445-3993
Practice Address - Street 1:401 S CENTER AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:PA
Practice Address - Zip Code:15501-2239
Practice Address - Country:US
Practice Address - Phone:814-445-4181
Practice Address - Fax:814-445-3993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD034119L208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA6486OtherHEALTH ANERICA
PALI126301OtherHIGHMARK BC BS
PA0006110430001Medicaid
PA1038093OtherGATEWAY HEALTH PLAN
PA556122OtherAETNA US HEALTH CARE
PA207930OtherUPMC HEALTH PLAN
PA0049662OtherUMWAHEALTH&RETIREMENT FUN
PA846398ML2OtherMAMSI
PA846398ML2OtherMAMSI
PA207930OtherUPMC HEALTH PLAN