Provider Demographics
NPI:1861445140
Name:UROLOGIC ASSOCIATES OF WESTERN PENNSYLVANIA, LTD.
Entity Type:Organization
Organization Name:UROLOGIC ASSOCIATES OF WESTERN PENNSYLVANIA, LTD.
Other - Org Name:STEPT & ARNHEIM UROLOGIC ASSOCIATES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:C
Authorized Official - Last Name:MUSMANNO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-781-6448
Mailing Address - Street 1:200 DELAFIELD ROAD
Mailing Address - Street 2:SUITE 3060
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15215-3205
Mailing Address - Country:US
Mailing Address - Phone:412-781-6448
Mailing Address - Fax:412-781-1350
Practice Address - Street 1:200 DELAFIELD ROAD
Practice Address - Street 2:SUITE 3060
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15215-3205
Practice Address - Country:US
Practice Address - Phone:412-781-6448
Practice Address - Fax:412-781-1350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2011-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD041755L174400000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA11348OtherUPMC HEALTHPLAN
PA1292643Medicaid
PA1292643Medicaid
PA627677KJSMedicare PIN