Basic Information
| Provider Information | |||||||||
| NPI: | 1982800330 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EUGENE T DANKO MD LTD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 503 VALHALLA DR | ||||||||
| Address2: | |||||||||
| City: | SEWICKLEY | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151439335 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4127413390 | ||||||||
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| Practice Location | |||||||||
| Address1: | 890 BEAVER GRADE RD | ||||||||
| Address2: | |||||||||
| City: | MOON TOWNSHIP | ||||||||
| State: | PA | ||||||||
| PostalCode: | 151082653 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4122699995 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/22/2007 | ||||||||
| LastUpdateDate: | 01/11/2008 | ||||||||
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| AuthorizedOfficialLastName: | DANKO | ||||||||
| AuthorizedOfficialFirstName: | EUGENE | ||||||||
| AuthorizedOfficialMiddleName: | THOMAS | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4127413390 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0204X | MD029049L | PA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology |
ID Information
| ID | Type | State | Issuer | Description | 0653025 | 05 | PA | MEDICAID |