Provider Demographics
NPI:1245462043
Name:OSTEOPATHIC CARDIOLOGY ASSOCIATES, LLC
Entity type:Organization
Organization Name:OSTEOPATHIC CARDIOLOGY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:ESPER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:814-866-2311
Mailing Address - Street 1:4002 SCHAPER AVENUE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508
Mailing Address - Country:US
Mailing Address - Phone:814-866-2311
Mailing Address - Fax:814-860-8111
Practice Address - Street 1:4002 SCHAPER AVENUE
Practice Address - Street 2:SUITE A
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508
Practice Address - Country:US
Practice Address - Phone:814-866-2311
Practice Address - Fax:814-860-8111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-13
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1023756540001Medicaid
PA002116332OtherHIGHMARK BLUE SHIELD
PA171415Medicare PIN