Basic Information
| Provider Information | |||||||||
| NPI: | 1306805940 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | US HEART AND VASCULAR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 363 VANADIUM RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152431497 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4124298840 | ||||||||
| FaxNumber: | 4124298067 | ||||||||
| Practice Location | |||||||||
| Address1: | 363 VANADIUM RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152431497 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4124298840 | ||||||||
| FaxNumber: | 4124298067 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2006 | ||||||||
| LastUpdateDate: | 11/04/2013 | ||||||||
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| AuthorizedOfficialLastName: | HUNSBERGER | ||||||||
| AuthorizedOfficialFirstName: | DIANE | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 4122780525 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RC0000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 15718640016 | 05 | PA | MEDICAID |