Provider Demographics
NPI:1447204128
Name:VASCULAR ACCESS CENTER OF PITTSBURGH LLC
Entity Type:Organization
Organization Name:VASCULAR ACCESS CENTER OF PITTSBURGH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:SETH
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-382-3680
Mailing Address - Street 1:2929 ARCH STREET
Mailing Address - Street 2:SUITE 1705
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-2866
Mailing Address - Country:US
Mailing Address - Phone:215-382-3680
Mailing Address - Fax:215-401-6772
Practice Address - Street 1:51 DUTILH RD STE 100
Practice Address - Street 2:
Practice Address - City:CRANBERRY TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:16066-4148
Practice Address - Country:US
Practice Address - Phone:412-683-4504
Practice Address - Fax:412-383-4505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207RN0300X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1557165OtherGATEWAY HEALTH PLAN
PA716920OtherUPMC
PA001881358OtherHIGHMARK BLUE SHIELD
PA1454576OtherAETNA
PA187194OtherUNISON
PA1016627830001Medicaid
PADF1590OtherRAILROAD MEDICARE
PADF1590OtherRAILROAD MEDICARE