Provider Demographics
NPI:1457430803
Name:BENJAMIN SHTRAHMAN MD
Entity Type:Organization
Organization Name:BENJAMIN SHTRAHMAN MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHTRAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-369-3911
Mailing Address - Street 1:9104 BABCOCK BLVD
Mailing Address - Street 2:STE 1107
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5818
Mailing Address - Country:US
Mailing Address - Phone:412-369-3911
Mailing Address - Fax:412-369-3949
Practice Address - Street 1:9104 BABCOCK BLVD
Practice Address - Street 2:STE 1107
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5818
Practice Address - Country:US
Practice Address - Phone:412-369-3911
Practice Address - Fax:412-369-3949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD049095L2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAV0Z080OtherUPMC HEALTH PLAN
PA1024279OtherGATEWAY HEALTH PLAN
PA1394246OtherHIGHMARK BLUE SHIELD
PA000000092966OtherUNISON
PA0015261250002Medicaid
PAV0Z080OtherUPMC HEALTH PLAN