Provider Demographics
NPI:1023084472
Name:WEINER, DEBRA
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:WEINER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 CENTRE AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-3721
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5750 CENTRE AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3721
Practice Address - Country:US
Practice Address - Phone:412-655-8030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD064602L207RG0300X
PAAK000561L171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE42915Medicare UPIN
PA004874Medicare PIN
PA004874JJFMedicare ID - Type Unspecified