Provider Demographics
NPI:1508932674
Name:ROY J SARTORI DO INC
Entity Type:Organization
Organization Name:ROY J SARTORI DO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SARTORI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:724-981-9306
Mailing Address - Street 1:2500 HIGHLAND RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-4601
Mailing Address - Country:US
Mailing Address - Phone:724-981-9306
Mailing Address - Fax:724-981-3003
Practice Address - Street 1:2500 HIGHLAND RD
Practice Address - Street 2:SUITE 105
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-4601
Practice Address - Country:US
Practice Address - Phone:724-981-9306
Practice Address - Fax:724-981-3003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-004082-L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007483460005Medicaid
PA1007483460005Medicaid
PA159841Medicare ID - Type UnspecifiedPROVIDER NUMBER