Provider Demographics
NPI:1851363683
Name:MT. LEBANON CHIROPRACTIC
Entity Type:Organization
Organization Name:MT. LEBANON CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:AUSLANDER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:412-561-4447
Mailing Address - Street 1:396 BEVERLY RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15216-1548
Mailing Address - Country:US
Mailing Address - Phone:412-561-4447
Mailing Address - Fax:412-561-6371
Practice Address - Street 1:396 BEVERLY RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15216-1548
Practice Address - Country:US
Practice Address - Phone:412-561-4447
Practice Address - Fax:412-561-6371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-5760-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1661499Medicaid
PAU54129Medicare UPIN
PA1661499Medicaid