Provider Demographics
NPI:1154466563
Name:GREATER PITTSBURGH NEUROLOGY PC
Entity Type:Organization
Organization Name:GREATER PITTSBURGH NEUROLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARETSKAYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-232-8683
Mailing Address - Street 1:1350 LOCUST ST
Mailing Address - Street 2:STE 402
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-4738
Mailing Address - Country:US
Mailing Address - Phone:412-232-8683
Mailing Address - Fax:412-232-8670
Practice Address - Street 1:1350 LOCUST ST
Practice Address - Street 2:STE 402
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-4738
Practice Address - Country:US
Practice Address - Phone:412-232-8683
Practice Address - Fax:412-232-8670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD069227L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100861479001Medicaid
PAH15067Medicare UPIN
PA100861479001Medicaid