Provider Demographics
NPI:1114022787
Name:THE CENTER FOR UROLOGIC CARE, PC
Entity Type:Organization
Organization Name:THE CENTER FOR UROLOGIC CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:LUTINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-661-3400
Mailing Address - Street 1:5750 CENTRE AVE
Mailing Address - Street 2:SUITE 395
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-3721
Mailing Address - Country:US
Mailing Address - Phone:412-661-3400
Mailing Address - Fax:412-661-5885
Practice Address - Street 1:651 COLLIERS WAY STE 509
Practice Address - Street 2:
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-5054
Practice Address - Country:US
Practice Address - Phone:412-661-3400
Practice Address - Fax:412-661-5885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0008874000Medicaid
PA1007761350001Medicaid
WV9246191Medicare ID - Type Unspecified
WV0008874000Medicaid