Provider Demographics
NPI:1093945529
Name:MAFFEI, GAE T (TANA) (MED)
Entity Type:Individual
Prefix:MS
First Name:GAE
Middle Name:T (TANA)
Last Name:MAFFEI
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8235 OHIO RIVER BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15202-1594
Mailing Address - Country:US
Mailing Address - Phone:412-766-4030
Mailing Address - Fax:412-766-0476
Practice Address - Street 1:8235 OHIO RIVER BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15202-1594
Practice Address - Country:US
Practice Address - Phone:412-766-4030
Practice Address - Fax:412-766-0476
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-17
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007529660001Medicaid