Basic Information
Provider Information
NPI: 1386687846
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOOKER
FirstName: MIRIAM
MiddleName: G
NamePrefix: MS.
NameSuffix:  
Credential: P.A.-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1000 BOWER HILL ROAD
Address2: ST CLAIR HOSPITAL - AFFILIATE BILLING - PAMALYN
City: PITTSBURGH
State: PA
PostalCode: 152431873
CountryCode: US
TelephoneNumber: 4129422548
FaxNumber:  
Practice Location
Address1: 1050 BOWER HILL RD STE 204
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152431868
CountryCode: US
TelephoneNumber: 4129425728
FaxNumber: 4129425738
Other Information
ProviderEnumerationDate: 06/13/2006
LastUpdateDate: 03/08/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/08/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363AM0700XMA052573PAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical

No ID Information.


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