Provider Demographics
NPI:1003860818
Name:MERCY NEUROSURGERY GROUP
Entity Type:Organization
Organization Name:MERCY NEUROSURGERY GROUP
Other - Org Name:PITTSBURGH NEUROSURGERY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:HODGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-471-4772
Mailing Address - Street 1:1501 LOCUST ST
Mailing Address - Street 2:SUITE 224
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-5136
Mailing Address - Country:US
Mailing Address - Phone:412-471-4772
Mailing Address - Fax:412-471-0659
Practice Address - Street 1:1501 LOCUST ST
Practice Address - Street 2:SUITE 224
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-5136
Practice Address - Country:US
Practice Address - Phone:412-471-4772
Practice Address - Fax:412-471-0659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2007-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1008195000001Medicaid
PA1008195000001Medicaid