Provider Demographics
NPI:1346520772
Name:UPMC COMMUNITY MEDICINE-INC
Entity Type:Organization
Organization Name:UPMC COMMUNITY MEDICINE-INC
Other - Org Name:AYESHA HOSSAIN MD AND ASSOCIATES-UPMC
Other - Org Type:Other Name
Authorized Official - Title/Position:SR.DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:T
Authorized Official - Last Name:EHALT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-647-0943
Mailing Address - Street 1:1111 LOWRY AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-3063
Mailing Address - Country:US
Mailing Address - Phone:724-523-5721
Mailing Address - Fax:724-527-6188
Practice Address - Street 1:1111 LOWRY AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:JEANNETTE
Practice Address - State:PA
Practice Address - Zip Code:15644-3063
Practice Address - Country:US
Practice Address - Phone:724-523-5721
Practice Address - Fax:724-527-6188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-17
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA042490Medicare PIN