Provider Demographics
NPI:1699862045
Name:SUBBIAH CARDIOLOGY ASSOCIATES, LTD
Entity type:Organization
Organization Name:SUBBIAH CARDIOLOGY ASSOCIATES, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THEVARAYA
Authorized Official - Middle Name:N
Authorized Official - Last Name:SUBBIAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-283-6668
Mailing Address - Street 1:122 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-5752
Mailing Address - Country:US
Mailing Address - Phone:724-283-6668
Mailing Address - Fax:724-283-6625
Practice Address - Street 1:122 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-5752
Practice Address - Country:US
Practice Address - Phone:724-283-6668
Practice Address - Fax:724-283-6625
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD021876E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA129506Medicare ID - Type Unspecified