Provider Demographics
NPI:1710292446
Name:PINNAKA, SUBHASH CHANDRA BOSE (MD)
Entity Type:Individual
Prefix:DR
First Name:SUBHASH
Middle Name:CHANDRA BOSE
Last Name:PINNAKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 KIM LN
Mailing Address - Street 2:
Mailing Address - City:WINDBER
Mailing Address - State:PA
Mailing Address - Zip Code:15963-8722
Mailing Address - Country:US
Mailing Address - Phone:914-493-1939
Mailing Address - Fax:
Practice Address - Street 1:STATE RT. 1014
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:PA
Practice Address - Zip Code:15779-0111
Practice Address - Country:US
Practice Address - Phone:724-459-8000
Practice Address - Fax:724-459-4498
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-18
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4584052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry