Provider Demographics
NPI:1659004604
Name:KANE, BRIAN (BA)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:KANE
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:PA
Mailing Address - Zip Code:15009-2905
Mailing Address - Country:US
Mailing Address - Phone:570-878-2097
Mailing Address - Fax:
Practice Address - Street 1:100 N BELLEFIELD AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-2600
Practice Address - Country:US
Practice Address - Phone:412-246-5619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health