Provider Demographics
NPI:1831153683
Name:EDSYS INC
Entity type:Organization
Organization Name:EDSYS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT PRINCIPAL
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:M ED
Authorized Official - Phone:412-690-2489
Mailing Address - Street 1:717 LIBERTY AVE
Mailing Address - Street 2:SUITE 900
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-3511
Mailing Address - Country:US
Mailing Address - Phone:412-690-2489
Mailing Address - Fax:412-690-2316
Practice Address - Street 1:717 LIBERTY AVENUE
Practice Address - Street 2:SUITE 900
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-3511
Practice Address - Country:US
Practice Address - Phone:412-690-2489
Practice Address - Fax:412-690-2316
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EDSYS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1011451950001Medicaid