Ilumina Life Center, P.C.

Primary specialty

Pain Medicine (Anesthesiology) PhysicianTaxonomy code 207LP2900X

Legal business name

ILUMINA LIFE CENTER, P.C.

Practice address

507 Tire Hill Rd
Suite 100
Johnstown, PA 15905-7311

Phone

(814) 467-4055

Fax

(814) 262-9816

NPI assigned

Aug 19, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Florentina Mayko

Title

Ceo

Phone

(814) 467-4055

Specialties & licenses 2

Addresses

Tax ID family

Ilumina Life Center PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Ilumina Life Center, P.C.

  • Interventional Pain Medicine Physician
  • Burnham, PA
  • NPI 1942686753
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1439942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525651200000",
    "number": "1295101715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 JAYCEE DR",
            "address_2": "SUITE 10",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159043650",
            "telephone_number": "814-467-4055",
            "fax_number": "814-626-8161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 TIRE HILL RD",
            "address_2": "SUITE 100",
            "city": "JOHNSTOWN",
            "state": "PA",
            "postal_code": "159057311",
            "telephone_number": "814-467-4055",
            "fax_number": "814-262-9816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILUMINA LIFE CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-19",
        "last_updated": "2018-05-07",
        "status": "A",
        "authorized_official_last_name": "MAYKO",
        "authorized_official_first_name": "FLORENTINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "814-467-4055"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Icare Medical
• Jospeh S Ieni, OD
• Ikram U. Haque, MD, PC
• Muhammad Imtiaz, M.D.
• Independence at Home
• Independence at Home LLC.
• Independent Family Services
• Independent Family Services, Inc.

• Pain Medicine (Anesthesiology) Physician in Johnstown, PA
• Providers in Johnstown, PA by specialty
• Pain Medicine (Anesthesiology) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.