Basic Information
| Provider Information | |||||||||
| NPI: | 1801891593 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PILLA | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 725 CHERRINGTON PKWY | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | MOON TOWNSHIP | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151084318 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4122621000 | ||||||||
| FaxNumber: | 4122624607 | ||||||||
| Practice Location | |||||||||
| Address1: | 725 CHERRINGTON PKWY | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | MOON TOWNSHIP | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151084318 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4122621000 | ||||||||
| FaxNumber: | 4122624607 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2005 | ||||||||
| LastUpdateDate: | 10/12/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | OS010991L | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 000000195093 | 01 | OH | ANTHEM BC/BS | OTHER | 00025613701 | 01 | NY | UNIVERA | OTHER | 2242791 | 05 | OH | MEDICAID | PI924251 | 01 | PA | HIGHMARK BC/BS | OTHER | 02581542 | 05 | NY | MEDICAID | 0018397740002 | 05 | PA | MEDICAID | 118905 | 05 | PA | MEDICAID |