Provider Demographics
NPI:1508843848
Name:USDL PITTSBURGH, INC.
Entity Type:Organization
Organization Name:USDL PITTSBURGH, INC.
Other - Org Name:CENTRE COMMONS MRI & CT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-323-2594
Mailing Address - Street 1:23110 STATE RD 54
Mailing Address - Street 2:PMB 292
Mailing Address - City:LUTZ
Mailing Address - State:FL
Mailing Address - Zip Code:33549-4566
Mailing Address - Country:US
Mailing Address - Phone:352-578-2055
Mailing Address - Fax:813-971-0818
Practice Address - Street 1:5750 CENTRE AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3761
Practice Address - Country:US
Practice Address - Phone:412-661-6861
Practice Address - Fax:412-661-6870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012458120001Medicaid
PAP00056706OtherRAILROAD MEDICARE
PA022577Medicare ID - Type Unspecified