Provider Demographics
NPI:1639258510
Name:OBSTETRICAL & GYNECOLOGICAL ASSOC OF PITTSBURGH, INC
Entity Type:Organization
Organization Name:OBSTETRICAL & GYNECOLOGICAL ASSOC OF PITTSBURGH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/VP
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:A
Authorized Official - Last Name:KREMSER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-621-7575
Mailing Address - Street 1:3380 BLVD OF THE ALLIES
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3125
Mailing Address - Country:US
Mailing Address - Phone:412-621-7575
Mailing Address - Fax:412-621-7655
Practice Address - Street 1:3380 BLVD OF THE ALLIES
Practice Address - Street 2:SUITE 1
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3125
Practice Address - Country:US
Practice Address - Phone:412-621-7575
Practice Address - Fax:412-621-7655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1760660OtherHIGHMARK #
165570OtherGROUP BS #
165570Medicare ID - Type UnspecifiedGROUP MEDICARE #