Provider Demographics
NPI:1457861973
Name:PRISTINE PATH PLLC
Entity Type:Organization
Organization Name:PRISTINE PATH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:HARSHAL
Authorized Official - Middle Name:ARUN
Authorized Official - Last Name:MULHERKAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-726-8857
Mailing Address - Street 1:1511 SHAKER CT
Mailing Address - Street 2:
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-8790
Mailing Address - Country:US
Mailing Address - Phone:412-726-8857
Mailing Address - Fax:
Practice Address - Street 1:3408 BABCOCK BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-2402
Practice Address - Country:US
Practice Address - Phone:412-726-8857
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-10
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Multi-Specialty