Provider Demographics
NPI:1114947710
Name:NITZBERG, ROBERT S (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:S
Last Name:NITZBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2349 MILL ST
Mailing Address - Street 2:
Mailing Address - City:ALIQUIPPA
Mailing Address - State:PA
Mailing Address - Zip Code:15001-2219
Mailing Address - Country:US
Mailing Address - Phone:412-283-6262
Mailing Address - Fax:
Practice Address - Street 1:12 QUAKER VILLAGE SHOPPING CTR
Practice Address - Street 2:OHIO RIVER BLVD STE 2
Practice Address - City:LEETSDALE
Practice Address - State:PA
Practice Address - Zip Code:15056-1206
Practice Address - Country:US
Practice Address - Phone:724-773-4502
Practice Address - Fax:412-749-6787
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD018295E207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0009555180001Medicaid
PA0009555180001Medicaid
B34347Medicare UPIN