Provider Demographics
NPI:1245292101
Name:CRANBERRY PEDIATRICS PC
Entity type:Organization
Organization Name:CRANBERRY PEDIATRICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:E
Authorized Official - Last Name:HUWE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:724-742-3257
Mailing Address - Street 1:8001 ROWAN RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-3616
Mailing Address - Country:US
Mailing Address - Phone:724-742-3257
Mailing Address - Fax:724-742-3256
Practice Address - Street 1:8001 ROWAN RD
Practice Address - Street 2:SUITE 205
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066-3616
Practice Address - Country:US
Practice Address - Phone:724-742-3257
Practice Address - Fax:724-742-3256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042157L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100022OtherUPMC COMMERCIAL
PA1511801OtherGATEWAY
PA7012155OtherAETNA
PA914684OtherHIGHMARK GROUP NUMBER
PAE78647OtherHEALTH ASSURANCE
PA1011955170002Medicaid
PA1128820OtherCIGNA HEALTHCARE
PAE78647OtherHEALTH AMERICA
PA000000061140OtherUNISON
PA2324618OtherUNITED HEALTHCARE
PAE78647OtherCARELINK
PA100022OtherUPMC FOR YOU
PA000000061140OtherUNISON
PA100022OtherUPMC COMMERCIAL
PA1511801OtherGATEWAY
PA=========OtherBOILERMAKERS
PA1011955170002Medicaid
PAE78647OtherCARELINK
PAE78647OtherHEALTH ASSURANCE
PA100022OtherUPMC FOR YOU