Provider Demographics
NPI:1700877487
Name:ASSOCIATES IN GASTROENTEROLOGY
Entity Type:Organization
Organization Name:ASSOCIATES IN GASTROENTEROLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:MLECKO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-367-4250
Mailing Address - Street 1:9000 PERRY HWY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5367
Mailing Address - Country:US
Mailing Address - Phone:412-367-4250
Mailing Address - Fax:412-367-7133
Practice Address - Street 1:701 BROAD ST
Practice Address - Street 2:SEWICKLEY VALLEY HOSPITAL
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1652
Practice Address - Country:US
Practice Address - Phone:412-367-4250
Practice Address - Fax:412-367-7133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-02
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009804590007Medicaid
PA093040Medicare PIN