Provider Demographics
NPI:1063466233
Name:ZUCKERMAN FAMILY PRACTICE
Entity Type:Organization
Organization Name:ZUCKERMAN FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MYLES
Authorized Official - Middle Name:H
Authorized Official - Last Name:ZUCKERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-922-6262
Mailing Address - Street 1:2500 BALDWICK RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15205-4140
Mailing Address - Country:US
Mailing Address - Phone:412-922-6262
Mailing Address - Fax:412-922-5026
Practice Address - Street 1:2500 BALDWICK RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-4140
Practice Address - Country:US
Practice Address - Phone:412-922-6262
Practice Address - Fax:412-922-5026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA5196484OtherAETNA ID NUMBER
PA993357OtherHIGHMARK ID NUMBER
PA=========OtherUPMC HEALTH PLAN
PA993357OtherHIGHMARK ID NUMBER