Basic Information
| Provider Information | |||||||||
| NPI: | 1609816974 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | C & E RADIOLOGISTS PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7 ACEE DRIVE | ||||||||
| Address2: | |||||||||
| City: | NATRONA HEIGHTS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15065 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002235544 | ||||||||
| FaxNumber: | 7242943206 | ||||||||
| Practice Location | |||||||||
| Address1: | 406 W OAK STREET | ||||||||
| Address2: | |||||||||
| City: | TITUSVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 16354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8148271851 | ||||||||
| FaxNumber: | 7242264515 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/07/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | NEWCOMER | ||||||||
| AuthorizedOfficialFirstName: | DON | ||||||||
| AuthorizedOfficialMiddleName: | B | ||||||||
| AuthorizedOfficialTitleorPosition: | PRACTICE ADMIN | ||||||||
| AuthorizedOfficialTelephone: | 7242264510 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | JR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 1011278940001 | 01 | MEDICAL ASST | OTHER | 1011278940001 | 05 | PA | MEDICAID | 352438 | 01 | HEALTH AMERICA | OTHER | 1624770 | 01 | HIGHMARK GROUP # | OTHER | DC0269 | 01 | RR MEDICARE | OTHER |