Provider Demographics
NPI:1649238825
Name:GREATER PITTSBURGH PEDIATRIC CENTER
Entity Type:Organization
Organization Name:GREATER PITTSBURGH PEDIATRIC CENTER
Other - Org Name:GREATER PITTSBURGH MEDICAL CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:NGOZI
Authorized Official - Last Name:UDEKWU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-566-1568
Mailing Address - Street 1:1811 BOULEVARD OF THE ALLIES
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219
Mailing Address - Country:US
Mailing Address - Phone:412-566-1568
Mailing Address - Fax:412-232-1926
Practice Address - Street 1:1811 BOULEVARD OF THE ALLIES
Practice Address - Street 2:SUITE 200
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219
Practice Address - Country:US
Practice Address - Phone:412-566-1568
Practice Address - Fax:412-232-1926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-060747-L261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care