Organization
EXTREMITY IMAGING PARTNERS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
A JEROME DIGIACOBBE (CEO)
(866) 398-7364
Entity
Organization
Contact information
Practice address
4500 BROOKTREE RD, STE 100, WEXFORD, PA 15090-9289
(866) 398-7364
(866) 267-0144
Mailing address
4500 BROOKTREE RD, STE 300, WEXFORD, PA 15090-9289
(866) 398-7364
(866) 267-0144
Taxonomy
Speciality
Code
Description
License number
State
2471M1202X
Magnetic Resonance Imaging Radiologic Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000340701
ANTHEM BCBS
IN
01
—
000000340701
ANTHEM BCBS
OH
01
—
000000378160
ANTHEM BCBS-DAYTON
OH
05
—
1009572010001
—
PA
05
—
1009572010002
—
PA
05
—
1009572010003
—
PA
05
—
1009572010004
—
PA
05
—
200423690A
—
KS
05
—
2273614
—
OH
01
—
258396
HEALTH ASSURANCE
PA
01
—
300686212
W/C US DEPT OF LABOR OWPC
PA
01
—
7823651
AETNA
PA
01
—
PA255
ONE CALL MEDICAL
PA
Enumeration date
10/25/2005
Last updated
07/08/2009
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