Provider Demographics
NPI:1063417350
Name:MCC CARDIOLOGY ASSOCIATES, INC.
Entity type:Organization
Organization Name:MCC CARDIOLOGY ASSOCIATES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LEAD PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:GENERALOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-232-8011
Mailing Address - Street 1:1518 FORBES AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-5112
Mailing Address - Country:US
Mailing Address - Phone:412-232-5546
Mailing Address - Fax:412-232-5548
Practice Address - Street 1:1350 LOCUST ST
Practice Address - Street 2:STE 300
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-4738
Practice Address - Country:US
Practice Address - Phone:412-232-8011
Practice Address - Fax:412-232-5639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA600678JULMedicare ID - Type Unspecified