Provider Demographics
NPI:1023115268
Name:BEGLY, ERIC (PAC)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:BEGLY
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 DELAFIELD RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15215-3247
Mailing Address - Country:US
Mailing Address - Phone:412-648-9670
Mailing Address - Fax:
Practice Address - Street 1:1606 CARMODY CT STE 202
Practice Address - Street 2:
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-8566
Practice Address - Country:US
Practice Address - Phone:724-933-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X, 363AM0700X
PAMA002043L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PWS34112Medicare UPIN
PA835279Medicare ID - Type UnspecifiedMEDICARE