Provider Demographics
NPI:1871702589
Name:COVE RADIOLOGY ASSOCIATES, PC
Entity type:Organization
Organization Name:COVE RADIOLOGY ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:L
Authorized Official - Last Name:DIEHL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-224-2141
Mailing Address - Street 1:105 NASON DR
Mailing Address - Street 2:
Mailing Address - City:ROARING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:16673-1202
Mailing Address - Country:US
Mailing Address - Phone:814-224-2141
Mailing Address - Fax:
Practice Address - Street 1:105 NASON DR
Practice Address - Street 2:
Practice Address - City:ROARING SPRING
Practice Address - State:PA
Practice Address - Zip Code:16673-1202
Practice Address - Country:US
Practice Address - Phone:814-224-2141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADF84466OtherRR MEDICARE
PA1019423100001Medicaid
PA1965776OtherBLUE SHIELD
PA1019423100001Medicaid