Provider Demographics
NPI:1780909580
Name:CHARLES A. DEFRANCESCO, MD
Entity type:Organization
Organization Name:CHARLES A. DEFRANCESCO, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:A
Authorized Official - Last Name:DEFRANCESCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-850-8744
Mailing Address - Street 1:1699 WASHINGTON RD
Mailing Address - Street 2:SUITE 307
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228-1629
Mailing Address - Country:US
Mailing Address - Phone:412-831-3744
Mailing Address - Fax:412-831-5663
Practice Address - Street 1:100 BRUSH RUN RD
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-8753
Practice Address - Country:US
Practice Address - Phone:724-691-0354
Practice Address - Fax:724-691-0362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-05
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD029492207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB35208Medicare UPIN
PA081206Medicare PIN