Otar Datiashvili
LIBERTY EMERGENCY PHYSICIANS LLC


Address: 250 S 21st St, Easton, PA 18042-3851
Phone: 6102504000

Otar Datiashvili (NPI# 1083096572, PAC ID# 3678882214) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is EMERGENCY MEDICINE.

Physician Overview

Nation Provider ID (NPI) 1083096572
PAC ID by PECOS 3678882214
Professional Enrollment ID I20171218002729
Full Name Otar Datiashvili
Organization Legal Name LIBERTY EMERGENCY PHYSICIANS LLC
Address 250 S 21st St
Easton
PA 18042-3851
Phone Number 6102504000
Gender M
Graduation Year 2012
Primary Specialty EMERGENCY MEDICINE
Group Practice PAC ID 5890895874
Number of Group Practice Members 11
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
390162 EASTON HOSPITAL

Other Locations

Address Phone Organization
250 S 21st St, Easton, PA 18042-3851 6102504000 LIBERTY EMERGENCY PHYSICIANS LLC
1500 N James St, Rome Memorial Hospital, Rome, NY 13440-2844 3153387035 EMERGENCY PHYSICIAN SERVICES OF NEW YORK, P.C.

Organization Information

Organization Legal Name LIBERTY EMERGENCY PHYSICIANS LLC
Physicians 1

Office Location

Street Address 250 S 21ST ST
City EASTON
State PA
Zip 18042-3851

Physicians in the same location

Name Specialty Organization Address
Jyothi Kudakandira Undefined Physician Type (specify) Apogee Medical Group of Pennsylvania PC 250 S 21st St, Easton, PA 18042-3851
Theresa K Kelly Certified Registered Nurse Anesthetist (crna) Capital Anesthesia Solutions of Pennsylvania LLC 250 S 21st St, Easton Hospital, Easton, PA 18042-3851
Dusan Damjanovic Anesthesiology Capital Anesthesia Solutions of Pennsylvania LLC 250 S 21st St, Easton Hospital, Easton, PA 18042-3851
Paul B Langevin Anesthesiology Capital Anesthesia Solutions of Pennsylvania LLC 250 S 21st St, Easton Hospital, Easton, PA 18042-3851
Donna E Ward Certified Registered Nurse Anesthetist (crna) Capital Anesthesia Solutions of Pennsylvania LLC 250 S 21st St, Easton Hospital, Easton, PA 18042-3851
Irina S Dash Certified Registered Nurse Anesthetist (crna) Capital Anesthesia Solutions of Pennsylvania LLC 250 S 21st St, Easton Hospital, Easton, PA 18042-3851
Danielle A Mcknight Certified Registered Nurse Anesthetist (crna) Capital Anesthesia Solutions of Pennsylvania LLC 250 S 21st St, Easton Hospital, Easton, PA 18042-3851
Alfred W Imbody Certified Registered Nurse Anesthetist (crna) Capital Anesthesia Solutions of Pennsylvania LLC 250 S 21st St, Easton Hospital, Easton, PA 18042-3851
Michael J Wechsler Physician Assistant Steward Medical Group Inc 250 S 21st St, Steward Medical Group, Easton, PA 18042-3851
William E Sotack Jr. Emergency Medicine Steward Emergency Physicians of Pennsylvania, Inc 250 S 21st St, Easton, PA 18042-3851
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Michael E Seldow Chiropractic 1631 Northampton St, Easton, PA 18042-3131
Jarid S Bleiman Chiropractic 1631 Northampton St, Easton, PA 18042-3131
Aparna U Tamaskar Family Medicine Steward Medical Group Inc 1723 Northampton St, Easton Internal Medical Associates, Easton, PA 18042-3133
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Competitor

Search similar physicians

City EASTON
Zip Code 18042
Specialty EMERGENCY MEDICINE
City + Specialty EASTON + EMERGENCY MEDICINE

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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