Provider Demographics
NPI:1093777229
Name:SAFYAN, SUSAN L (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:L
Last Name:SAFYAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 WASHINGTON RD
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228-1903
Mailing Address - Country:US
Mailing Address - Phone:412-440-0270
Mailing Address - Fax:412-440-0271
Practice Address - Street 1:607 WASHINGTON RD
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15228-1903
Practice Address - Country:US
Practice Address - Phone:412-440-0270
Practice Address - Fax:412-440-0271
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037398E207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAA92857Medicare UPIN
PA475631H2AMedicare ID - Type Unspecified