Provider Demographics
NPI:1578886255
Name:UPMC MERCY
Entity Type:Organization
Organization Name:UPMC MERCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AJ
Authorized Official - Middle Name:
Authorized Official - Last Name:PINEVICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-232-8080
Mailing Address - Street 1:100 CHATHAM PARK DR
Mailing Address - Street 2:APT # 511
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15220-2109
Mailing Address - Country:US
Mailing Address - Phone:412-626-4496
Mailing Address - Fax:
Practice Address - Street 1:1400 LOCUST ST
Practice Address - Street 2:UPMC MERCY, DEPARTMENT OF MEDICINE
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-5114
Practice Address - Country:US
Practice Address - Phone:412-232-8080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT195759261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center