Provider Demographics
NPI:1508838061
Name:NIREN, NEIL M (MD)
Entity Type:Individual
Prefix:
First Name:NEIL
Middle Name:M
Last Name:NIREN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9102 BABCOCK BLVD
Mailing Address - Street 2:STE 206
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237
Mailing Address - Country:US
Mailing Address - Phone:412-367-0808
Mailing Address - Fax:412-366-1584
Practice Address - Street 1:9102 BABCOCK BLVD
Practice Address - Street 2:STE 206
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237
Practice Address - Country:US
Practice Address - Phone:412-367-0808
Practice Address - Fax:412-366-1584
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2012-11-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD025703E207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
070012530OtherRAILROAD MEDICARE
PA0017134200OtherINDEPENDENCE BLUE SHIELD
PA0017113660003Medicaid
101724OtherUPMC HEALTH PLAN
PA22133OtherHIGHMARK BLUE SHIELD
PA22133OtherHIGHMARK BLUE SHIELD
B33457Medicare UPIN