Coaldale Cardiology, Inc.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD015292E Issued in PA

Legal business name

COALDALE CARDIOLOGY, INC.

Practice address

360 W Ruddle St
Coaldale, PA 18218-1027

Phone

(570) 645-0495

Fax

(570) 645-0497

NPI assigned

Jul 26, 2005

Organization subpart

No

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

Authorized official

Name

Robert L Dejoseph, MD

Title

Director

Phone

(570) 645-0495

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710987219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 W RUDDLE ST",
            "city": "COALDALE",
            "state": "PA",
            "postal_code": "182181027",
            "telephone_number": "570-645-0495",
            "fax_number": "570-645-0497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 W RUDDLE ST",
            "city": "COALDALE",
            "state": "PA",
            "postal_code": "182181027",
            "telephone_number": "570-645-0495",
            "fax_number": "570-645-0497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COALDALE CARDIOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEJOSEPH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "570-645-0495",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD015292E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1008165260001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Adams
• Devon M Bizarre, PA-C
• Carbon Schuylkill Community Hospital
• Carbon-Schuylkill Community Hospital, Inc.
• Coaldale Community Ambulance Association
• Dilliswar Sahoo MD PC
• Ethan Eichhorst
• Kathleen C Fishe, PA-C
• Diana Gomez, OTR/L; RT, (R), (CT)

• Internal Medicine Physician in Coaldale, PA
• Providers in Coaldale, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.