Provider Demographics
NPI:1336294560
Name:PAUL E. ANTALIK M.D., P.C.
Entity Type:Organization
Organization Name:PAUL E. ANTALIK M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:ANTALIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-795-1170
Mailing Address - Street 1:7125 SALTSBURG RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15235-2252
Mailing Address - Country:US
Mailing Address - Phone:412-795-1170
Mailing Address - Fax:412-795-1154
Practice Address - Street 1:7125 SALTSBURG RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15235-2252
Practice Address - Country:US
Practice Address - Phone:412-795-1170
Practice Address - Fax:412-795-1154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CK4549Medicare PIN
PA060118Medicare ID - Type UnspecifiedPROVIDER NUMBER