Organization
PENNSYLVANIA HEART AND VASCULAR GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL FRAIETTA (PRACTICE ADMINISTRATOR)
(215) 671-4280
Entity
Organization
Contact information
Practice address
261 OLD YORK RD, SUITE 214, JENKINTOWN, PA 19046-3706
(215) 885-4700
(215) 885-6861
Mailing address
261 OLD YORK RD, SUITE 214, JENKINTOWN, PA 19046-3706
(215) 885-4700
(215) 885-6861
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RC0001X
Clinical Cardiac Electrophysiology Physician
—
—
207RI0011X
Interventional Cardiology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0017838200003
—
PA
01
—
036234
MEDICARE ID
PA
Enumeration date
05/16/2006
Last updated
12/01/2014
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