Provider Demographics
NPI:1780850545
Name:WESTERN PENNSYLVANIA FAMILY MEDICINE ASSOCIATES
Entity Type:Organization
Organization Name:WESTERN PENNSYLVANIA FAMILY MEDICINE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENROLLMENT ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-330-5220
Mailing Address - Street 1:2057 ROUTE 130
Mailing Address - Street 2:
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-3801
Mailing Address - Country:US
Mailing Address - Phone:412-527-0991
Mailing Address - Fax:412-527-0990
Practice Address - Street 1:2057 ROUTE 130
Practice Address - Street 2:
Practice Address - City:JEANNETTE
Practice Address - State:PA
Practice Address - Zip Code:15644-3801
Practice Address - Country:US
Practice Address - Phone:412-527-0991
Practice Address - Fax:412-527-0990
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEST PENN PHYSICIAN PRACTICE NETWORK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-01
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA098763Medicare PIN