Provider Demographics
NPI:1497348890
Name:KUMAR, IVA SHAH (PSYD)
Entity Type:Individual
Prefix:
First Name:IVA
Middle Name:SHAH
Last Name:KUMAR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:IVA
Other - Middle Name:SANDIP
Other - Last Name:SHAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:615 WASHINGTON RD STE 500
Mailing Address - Street 2:
Mailing Address - City:MT LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:15228-1926
Mailing Address - Country:US
Mailing Address - Phone:412-343-6416
Mailing Address - Fax:412-343-6418
Practice Address - Street 1:795 PINE VALLEY DR STE 18
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15239-2800
Practice Address - Country:US
Practice Address - Phone:724-519-7150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-16
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS019223103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist