Provider Demographics
NPI:1023018124
Name:DERMATOLOGIC CARE INC
Entity Type:Organization
Organization Name:DERMATOLOGIC CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAWELSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-824-9600
Mailing Address - Street 1:3424 WILLIAM PENN HWY PENN CENTER EAST
Mailing Address - Street 2:BLDG 2 STE 221
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-5411
Mailing Address - Country:US
Mailing Address - Phone:412-824-9600
Mailing Address - Fax:412-824-9614
Practice Address - Street 1:3424 WILLIAM PENN HWY PENN CENTER EAST
Practice Address - Street 2:BLDG 2 STE 221
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-5411
Practice Address - Country:US
Practice Address - Phone:412-824-9600
Practice Address - Fax:412-824-9614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA047262L207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA770230OtherAETNA VSHC
PA761358OtherBLUE SHIELD
PA761358Medicare ID - Type Unspecified