Provider Demographics
NPI:1023246840
Name:VAN LAAR, AMBER
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:VAN LAAR
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 1:3501 5TH AVE
Mailing Address - Street 2:DEPT OF NEUROLOGY UNIVERSITY OF PITTSBURGH 7045 BST 3
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3301
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3501 5TH AVE
Practice Address - Street 2:DEPARTMENT OF NEUROLOGY 7045 BST 3
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3301
Practice Address - Country:US
Practice Address - Phone:412-692-4670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4513892084N0400X
PAMT195476390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program