Organization
EXTENDED CARE MEDICAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL SPECA D.O. (BUSINESS MANAGER)
(724) 375-3100
Entity
Organization
Contact information
Practice address
5824 LONGVIEW CIR, BRIDGEVILLE, PA 15017-1277
(724) 375-3100
(724) 375-5858
Mailing address
5824 LONGVIEW CIR, BRIDGEVILLE, PA 15017-1277
(724) 375-3100
(724) 375-5858
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010424740001
—
PA
01
—
1608513
BLUE SHIELD
PA
05
—
2712425
—
OH
01
—
3567805
AETNA
—
01
—
V0416B
UPMC
PA
Enumeration date
07/06/2006
Last updated
09/12/2008
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