Provider Demographics
NPI:1356319313
Name:WPIC PHYSICIAN PRACTICE CORP INC
Entity Type:Organization
Organization Name:WPIC PHYSICIAN PRACTICE CORP INC
Other - Org Name:UPMC BEHAVIORAL HEALTH ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:DILLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-246-6796
Mailing Address - Street 1:3811 OHARA ST
Mailing Address - Street 2:SUITE 274
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2593
Mailing Address - Country:US
Mailing Address - Phone:412-246-6792
Mailing Address - Fax:412-586-9532
Practice Address - Street 1:3811 OHARA ST
Practice Address - Street 2:SUITE 274
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2593
Practice Address - Country:US
Practice Address - Phone:412-246-6792
Practice Address - Fax:412-586-9532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017514140006Medicaid
PA0000028040Medicare ID - Type Unspecified