Healthcare Provider Details

I. General information

NPI: 1518996743
Provider Name (Legal Business Name): RAINELDO C SAQUIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 05/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 MAIN DR
NORTH WARREN PA
16365-5001
US

IV. Provider business mailing address

30 LAUREL AVE
KANE PA
16735-1620
US

V. Phone/Fax

Practice location:
  • Phone: 814-726-4317
  • Fax: 814-726-4447
Mailing address:
  • Phone: 814-837-7086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberMD035251L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: