Provider Demographics
NPI:1245449107
Name:MAURICE S CERUL MD PC
Entity type:Organization
Organization Name:MAURICE S CERUL MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAURICE
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:CERUL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-361-4144
Mailing Address - Street 1:401 SHADY AVE
Mailing Address - Street 2:STE B104
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206
Mailing Address - Country:US
Mailing Address - Phone:412-361-4144
Mailing Address - Fax:412-687-3949
Practice Address - Street 1:401 SHADY AVE
Practice Address - Street 2:STE B104
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206
Practice Address - Country:US
Practice Address - Phone:412-361-4144
Practice Address - Fax:412-687-3949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD008281E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1016766260001Medicaid
B35291Medicare UPIN
PA1016766260001Medicaid