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Organization
FAYETTE ONCOLOGY ASSOCIATES
Active
Organization
FAYETTE ONCOLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES E BOGOSTA (VICE PRESIDENT)
(412) 692-2451
Entity
Organization
Contact information
Practice address
51 BREWER DR, UNIONTOWN, PA 15401-8400
(724) 437-2503
(724) 437-8846
Mailing address
2 HOT METAL ST, QUANTUM ONE, N430, PITTSBURGH, PA 15203-2348
(412) 432-7706
(412) 432-7691
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
091787
MEDICARE IDTF
PA
05
—
1008852920003
—
PA
01
—
1564200
HIGHMARK
PA
01
—
P00639348
RAILROAD MEDICARE IDTF
PA
Enumeration date
04/13/2006
Last updated
02/16/2009
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