Provider Demographics
NPI:1164410940
Name:PURI, ANKUR (MD, FCCP)
Entity Type:Individual
Prefix:DR
First Name:ANKUR
Middle Name:
Last Name:PURI
Suffix:
Gender:M
Credentials:MD, FCCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9104 BABCOCK BLVD STE 2103
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5818
Mailing Address - Country:US
Mailing Address - Phone:412-748-5020
Mailing Address - Fax:412-367-3122
Practice Address - Street 1:9104 BABCOCK BLVD
Practice Address - Street 2:SUITE 2103
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5818
Practice Address - Country:US
Practice Address - Phone:412-748-5020
Practice Address - Fax:412-635-4971
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA436324207R00000X, 207RC0200X, 207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001912373Medicaid
NY02292744Medicaid
NY02292744Medicaid
153945Medicare PIN
NY02292744Medicaid