Provider Demographics
NPI:1922096163
Name:KANIA, ROBERT J (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:KANIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4815 LIBERTY AVE
Mailing Address - Street 2:SUITE M58
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2156
Mailing Address - Country:US
Mailing Address - Phone:412-681-1616
Mailing Address - Fax:412-681-6438
Practice Address - Street 1:4815 LIBERTY AVE
Practice Address - Street 2:SUITE M58
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2156
Practice Address - Country:US
Practice Address - Phone:412-681-1616
Practice Address - Fax:412-681-6438
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD0235553207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0210522000Medicaid
OH0579208Medicaid
PA0009005920010Medicaid
PA024550NHUMedicare PIN
PAP00469285Medicare PIN
WV0210522000Medicaid
PA0009005920010Medicaid