Basic Information
| Provider Information | |||||||||
| NPI: | 1063417350 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MCC CARDIOLOGY ASSOCIATES, INC. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | MCS CARDIOLOGY SPECIALISTS | ||||||||
| OtherOrganizationType: | 4 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1518 FORBES AVE | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152195112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4122325546 | ||||||||
| FaxNumber: | 4122325548 | ||||||||
| Practice Location | |||||||||
| Address1: | 1350 LOCUST ST | ||||||||
| Address2: | STE 300 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152194738 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4122328011 | ||||||||
| FaxNumber: | 4122325639 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2005 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | GENERALOVICH | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | LEAD PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 4122328011 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 173000000X | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Legal Medicine |
No ID Information.