Provider Demographics
NPI:1710968722
Name:GENERALOVICH, THOMAS
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:GENERALOVICH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UPMC PHYSICIAN SERVICES
Mailing Address - Street 2:200 LOTHROP STREET
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1350 LOCUST ST FL 1
Practice Address - Street 2:SUITE 100
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-4738
Practice Address - Country:US
Practice Address - Phone:412-232-9030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD024194E207RI0011X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1003715OtherGATEWAY HEALTH PLANS
PA222599OtherUNISON HEALTH PLANS
PA1693180OtherAETNA HMO
PA253516OtherUPMC
PA0009819570003Medicaid
PA612893700OtherUS DOL
PA020318OtherHIGHMARK BCBS
PA4230993OtherAETNA PPO
PAP00445199OtherRR MEDICARE
PA253516OtherUPMC
PAB33429Medicare UPIN