Provider Demographics
| NPI: | 1871535351 |
|---|---|
| Name: | ALLEGHENIES INDEPENDENT PHYSICIANS PC |
| Entity type: | Organization |
| Organization Name: | ALLEGHENIES INDEPENDENT PHYSICIANS PC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | PRESIDENT |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | CRAIG |
| Authorized Official - Middle Name: | H |
| Authorized Official - Last Name: | FOCKLER |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 814-266-5650 |
| Mailing Address - Street 1: | 336 BLOOMFIELD ST STE 201 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | JOHNSTOWN |
| Mailing Address - State: | PA |
| Mailing Address - Zip Code: | 15904-3271 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 814-535-7576 |
| Mailing Address - Fax: | 814-536-1369 |
| Practice Address - Street 1: | 336 BLOOMFIELD ST STE 201 |
| Practice Address - Street 2: | |
| Practice Address - City: | JOHNSTOWN |
| Practice Address - State: | PA |
| Practice Address - Zip Code: | 15904-3271 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 814-535-7576 |
| Practice Address - Fax: | 814-536-1369 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-06-11 |
| Last Update Date: | 2021-03-10 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| PA | MD059909L | 207R00000X |
| PA | OS005422L | 207Q00000X |
| PA | MD419819 | 207RP1001X |
| PA | MD027167E | 207W00000X |
| PA | MD425474 | 208600000X |
| PA | MA002741L | 363AM0700X |
| PA | MA002047L | 363AS0400X |
| PA | MD050085L | 207X00000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Multi-Specialty |
| No | 207W00000X | Allopathic & Osteopathic Physicians | Ophthalmology | Group - Multi-Specialty | |
| No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
| No | 363AM0700X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | Group - Multi-Specialty |
| No | 363AS0400X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| 1063497584 | Other | MUNZER, FRED NPI | |
| 1457336042 | Other | NPI MARLEY | |
| 1518947720 | Other | BUDAY, MICHAEL NPI NUM | |
| PA | 1538160262 | Other | ADEWALE OLALERE MD NPI |
| 1639154545 | Other | GUNNLAUGSON, BRIAN NPI | |
| 1346225869 | Other | AMPER, LEONARDO NPI NUM | |
| 1639154545 | Other | GUNNLAUGSON, BRIAN NPI | |
| F71329 | Medicare UPIN | ||
| C36648 | Medicare UPIN | ||
| H98545 | Medicare UPIN | ||
| 1518947720 | Other | BUDAY, MICHAEL NPI NUM | |
| S89716 | Medicare UPIN | ||
| 1063497584 | Other | MUNZER, FRED NPI | |
| 1457336042 | Other | NPI MARLEY | |
| PA | 1538160262 | Other | ADEWALE OLALERE MD NPI |
