Constantine N Petrochko, MD | |
110 N Main St, Greenville, PA 16125-1726 | |
(724) 588-2100 | |
Not Available |
Full Name | Constantine N Petrochko |
---|---|
Gender | Male |
Speciality | Radiology - Diagnostic Radiology |
Location | 110 N Main St, Greenville, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1881668440 | NPI | - | NPPES |
0015251910001 | Medicaid | PA | |
0381466 | Medicaid | OH | |
000000114390 | Other | OH | BC BS |
0690975 | Other | PA | BC BS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0202X | Radiology - Diagnostic Radiology | MD052081L (Pennsylvania) | Primary |
Entity Name | Diagnostic Imaging Consultants Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1841264405 PECOS PAC ID: 1850362161 Enrollment ID: O20040802000914 |
Mailing Address | Practice Location Address |
---|---|
Constantine N Petrochko, MD Po Box 73985, Cleveland, OH 44193-0002 Ph: (866) 338-6467 | Constantine N Petrochko, MD 110 N Main St, Greenville, PA 16125-1726 Ph: (724) 588-2100 |
Ronald P Brennan, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 110 N Main St, Greenville, PA 16125 Phone: 724-588-2100 | |
Matthew T Bee, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 110 N Main St, Greenville, PA 16125 Phone: 724-588-2100 | |
Dr. John Lada Miller, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 205 Hempfield Ave, Greenville, PA 16125 Phone: 724-588-2038 | |
Jaime H Montoya, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 110 N Main St, Greenville, PA 16125 Phone: 724-588-6366 | |
Scott F Pickering, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 110 N Main St, Greenville, PA 16125 Phone: 724-588-2100 |