Provider Demographics
NPI:1568679629
Name:BRIAN SZABO,DPM,PC
Entity Type:Organization
Organization Name:BRIAN SZABO,DPM,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SZABO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:724-981-1141
Mailing Address - Street 1:2501 SHENANGO VALLEY FWY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-2536
Mailing Address - Country:US
Mailing Address - Phone:724-981-1141
Mailing Address - Fax:724-981-1658
Practice Address - Street 1:2501 SHENANGO VALLEY FWY
Practice Address - Street 2:SUITE 2
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-2536
Practice Address - Country:US
Practice Address - Phone:724-981-1141
Practice Address - Fax:724-981-1658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002909L213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010471460004Medicaid
PAT29590Medicare UPIN
PA0010471460004Medicaid