Provider Demographics
NPI:1710921978
Name:PRISK, VICTOR ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:ROBERT
Last Name:PRISK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2490 MOSSIDE BLVD
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2760
Mailing Address - Country:US
Mailing Address - Phone:412-565-7013
Mailing Address - Fax:412-565-7015
Practice Address - Street 1:2490 MOSSIDE BLVD
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2760
Practice Address - Country:US
Practice Address - Phone:412-565-7013
Practice Address - Fax:412-565-7015
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD428341207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1016490010002Medicaid
PA101705HN3Medicare PIN