Provider Demographics
NPI:1124049762
Name:ALLIANCE CARDIOLOGY GROUP
Entity type:Organization
Organization Name:ALLIANCE CARDIOLOGY GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:SESTI-SPOHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-823-3113
Mailing Address - Street 1:21 YOST BLVD
Mailing Address - Street 2:FOREST HILLS PLAZA, SUITE 216
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15221-5283
Mailing Address - Country:US
Mailing Address - Phone:412-823-3113
Mailing Address - Fax:412-823-6361
Practice Address - Street 1:21 YOST BLVD
Practice Address - Street 2:FOREST HILLS PLAZA, SUITE 216
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-5283
Practice Address - Country:US
Practice Address - Phone:412-823-3113
Practice Address - Fax:412-823-6361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1629728OtherHIGHMARK GROUP ID#
PA1629728OtherHIGHMARK GROUP ID#