Provider Demographics
NPI:1710227483
Name:UNIVERSITY OF PITTSBURGH PHYSICIANS
Entity Type:Organization
Organization Name:UNIVERSITY OF PITTSBURGH PHYSICIANS
Other - Org Name:PATHOLOGY MCKEESPORT
Other - Org Type:Other Name
Authorized Official - Title/Position:SR.DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:T
Authorized Official - Last Name:EHALT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-647-0943
Mailing Address - Street 1:1500 FIFTH AVE
Mailing Address - Street 2:
Mailing Address - City:MCKEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15132-2422
Mailing Address - Country:US
Mailing Address - Phone:412-664-2000
Mailing Address - Fax:
Practice Address - Street 1:1500 FIFTH AVE
Practice Address - Street 2:
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132-2422
Practice Address - Country:US
Practice Address - Phone:412-664-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-18
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA044892Medicare PIN