Provider Demographics
NPI:1043651557
Name:UNIVERSITY OF PITTSBURGH MEDICAL CENTER DEPT OF MFS
Entity Type:Organization
Organization Name:UNIVERSITY OF PITTSBURGH MEDICAL CENTER DEPT OF MFS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BERNARD
Authorized Official - Middle Name:
Authorized Official - Last Name:COSTELLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD DMD
Authorized Official - Phone:412-648-6801
Mailing Address - Street 1:401 AMBERSON AVE
Mailing Address - Street 2:APT 151
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1454
Mailing Address - Country:US
Mailing Address - Phone:216-789-5928
Mailing Address - Fax:
Practice Address - Street 1:3471 5TH AVE
Practice Address - Street 2:1112 KAUFMANN BUILDING
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3215
Practice Address - Country:US
Practice Address - Phone:412-648-6801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-12
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital