Healthcare Provider Details

I. General information

NPI: 1063417350
Provider Name (Legal Business Name): MCC CARDIOLOGY ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1350 LOCUST ST STE 300
PITTSBURGH PA
15219-4738
US

IV. Provider business mailing address

1518 FORBES AVE
PITTSBURGH PA
15219-5112
US

V. Phone/Fax

Practice location:
  • Phone: 412-232-8011
  • Fax: 412-232-5639
Mailing address:
  • Phone: 412-232-5546
  • Fax: 412-232-5548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: THOMAS GENERALOVICH
Title or Position: LEAD PHYSICIAN
Credential: M.D.
Phone: 412-232-8011