MEDICARE: PENNSYLVANIA CARDIOTHORACIC SURGERY INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	MD028903E	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CJ3345	OTHER	PA	RR MEDICARE (GROUP)
3	780002061	OTHER	PA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548268550
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PENNSYLVANIA CARDIOTHORACIC SURGERY INC.

Provider Business Mailing Address
First Line	:	545 N RIVER ST
Second Line	:	SUITE 130
City	:	WILKES BARRE
State	:	PA
Zip	:	18702-2600
Country	:	US
Telephone Number	:	570-270-4455
Fax Number	:	570-270-4884

Provider Business Practice Location Address
First Line	:	545 N RIVER ST
Second Line	:	SUITE 130
City	:	WILKES BARRE
State	:	PA
Zip	:	18702-2600
Country	:	US
Telephone Number	:	570-270-4455
Fax Number	:	570-270-4884

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MICHAEL D. HAROSTOCK
Credential	:	MD
Telephone Number	:	570-270-4455

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	10/13/2014

Similar Medicare Providers

1962405894 — WILKES BARRE ASC., LP
Practice Location Address:

545 N RIVER ST
WILKES BARRE, PA
18702-2600

Practice Phone: 570-822-9010
Practice Fax: 570-270-6488

1437144839 — DR. AKRAM A ZALATIMO M.D.
Practice Location Address:

545 N RIVER ST , SUITE 110
WILKES BARRE, PA
18702-2600

Practice Phone: 570-270-7600
Practice Fax: 570-270-7602

1326096884 — LUCYANN M SCIANDRA DO
Practice Location Address:

545 N RIVER ST , SUITE 205
WILKES BARRE, PA
18702-2600

Practice Phone: 570-822-6036
Practice Fax: 570-829-1520

1386693687 — LINDA A SLAVOSKI MD
Practice Location Address:

545 N RIVER ST , SUITE 205
WILKES BARRE, PA
18702-2600

Practice Phone: 570-822-6036
Practice Fax: 570-829-1520

1144279209 — GARY RAYMOND DECKER MD
Practice Location Address:

545 N RIVER ST , SUITE 205
WILKES BARRE, PA
18702-2600

Practice Phone: 570-822-6036
Practice Fax: 570-829-1520

1154372373 — WYOMING VALLEY INFECTIOUS DISEASE ASSOC, PC
Practice Location Address:

545 N RIVER ST , SUITE 205
WILKES BARRE, PA
18702-2600

Practice Phone: 570-822-6036
Practice Fax: 570-829-1520

Directions to “PENNSYLVANIA CARDIOTHORACIC SURGERY INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.