Provider Demographics
NPI:1902340177
Name:WESTERN HEMATOLOGY ONCOLOGY GROUP P.S.C
Entity Type:Organization
Organization Name:WESTERN HEMATOLOGY ONCOLOGY GROUP P.S.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CASIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-892-2540
Mailing Address - Street 1:PO BOX 5075
Mailing Address - Street 2:PMB 205
Mailing Address - City:SAN GERMAN
Mailing Address - State:PR
Mailing Address - Zip Code:00683
Mailing Address - Country:US
Mailing Address - Phone:787-892-2540
Mailing Address - Fax:787-892-2540
Practice Address - Street 1:CALLE HERNAN ALVAREZ
Practice Address - Street 2:PLAZA METROPOLITANA SUITE 206
Practice Address - City:SAN GERMAN
Practice Address - State:PR
Practice Address - Zip Code:00683
Practice Address - Country:US
Practice Address - Phone:787-892-2540
Practice Address - Fax:787-892-2540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-07
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR11839174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR89619Medicare UPIN
PRH82123Medicare UPIN