Healthcare Provider Details
I. General information
NPI: 1275587222
Provider Name (Legal Business Name): JEFFERSON CARDIOLOGY ASSOCATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/22/2006
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1633 ROUTE 51 STE 103
JEFFERSON HILLS PA
15025-3652
US
IV. Provider business mailing address
PO BOX 18285
PITTSBURGH PA
15236
US
V. Phone/Fax
- Phone: 412-469-1500
- Fax: 412-469-1531
- Phone: 412-469-1500
- Fax: 412-469-1531
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 0006711210001 |
| Identifier Type | MEDICAID |
| Identifier State | PA |
| Identifier Issuer | |
VIII. Authorized Official
Name: DR.
GENNADY
GESKIN
Title or Position: PRESIDENT JEFFERSON CARDIOLOGY ASSN
Credential: MD
Phone: 412-469-1500