Provider Demographics
NPI:1508939836
Name:HEMOPHILIA CENTER OF WESTERN PA
Entity type:Organization
Organization Name:HEMOPHILIA CENTER OF WESTERN PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:D
Authorized Official - Last Name:WAHAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-209-7360
Mailing Address - Street 1:201 N CRAIG ST STE 500
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-1516
Mailing Address - Country:US
Mailing Address - Phone:412-209-7280
Mailing Address - Fax:412-209-7281
Practice Address - Street 1:3636 BOULEVARD OF THE ALLIES
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213
Practice Address - Country:US
Practice Address - Phone:412-209-7280
Practice Address - Fax:412-209-7281
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA58207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
225236OtherHEALTH AMERICA
DD6458OtherRAILRAOD MEDICARE
PA554607OtherHIGHMARK BLUE SHIELD
PA0340961000OtherINDEPENDENCE BLUE SHIELD
1508754OtherGATEWAY HEALTH PLAN
PA0018116010001Medicaid
DD6458OtherRAILRAOD MEDICARE
225236OtherHEALTH AMERICA