Provider Demographics
NPI:1780897413
Name:YATSUBA, EKATERINA
Entity type:Individual
Prefix:
First Name:EKATERINA
Middle Name:
Last Name:YATSUBA
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 1:275 CURRY HOLLOW RD
Mailing Address - Street 2:BUILDING ONE, SUITE 100
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15236-4631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:275 CURRY HOLLOW RD
Practice Address - Street 2:BUILDING ONE, SUITE 100
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15236-4631
Practice Address - Country:US
Practice Address - Phone:412-650-2375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD428398207VG0400X, 207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA270696OtherMED PLUS INDIVIDUAL
PA567466OtherHGHMARK PRODUCTS
PA1019655670001Medicaid
PACF4430OtherTRAVELERS MEDICARE
PAOA715991OtherMEDICARE GROUP
PA1564614OtherGATEWAY
PA7047952OtherAETNA
PA828844OtherHIGHMARK GROUP
PA1007451OtherGATEWAY GROUP
PA1019655670001Medicaid