Provider Demographics
NPI:1558620948
Name:CENTRAL PITTSBURGH PSYCHIATRIC SERVICES
Entity Type:Organization
Organization Name:CENTRAL PITTSBURGH PSYCHIATRIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUTKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-518-8719
Mailing Address - Street 1:20 CEDAR BLVD
Mailing Address - Street 2:SUITE 306
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15228-1330
Mailing Address - Country:US
Mailing Address - Phone:412-518-8719
Mailing Address - Fax:412-799-8747
Practice Address - Street 1:20 CEDAR BLVD
Practice Address - Street 2:SUITE 306
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15228-1330
Practice Address - Country:US
Practice Address - Phone:412-518-8719
Practice Address - Fax:412-799-8747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-07
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD449632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty