Provider Demographics
NPI:1104831429
Name:THE WESTERN PENNSYLVANIA HOSPITAL
Entity Type:Organization
Organization Name:THE WESTERN PENNSYLVANIA HOSPITAL
Other - Org Name:PEDIATRIC AND NEONATAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-578-1989
Mailing Address - Street 1:4800 FRIENDSHIP AVE
Mailing Address - Street 2:3RD FLOOR WEST TOWER
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-1722
Mailing Address - Country:US
Mailing Address - Phone:412-578-5858
Mailing Address - Fax:412-578-1529
Practice Address - Street 1:4800 FRIENDSHIP AVE
Practice Address - Street 2:3RD FLOOR WEST TOWER
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1722
Practice Address - Country:US
Practice Address - Phone:412-578-5858
Practice Address - Fax:412-578-1529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007277200001Medicaid