Basic Information
Provider Information
NPI: 1578808267
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KANE
FirstName: ERIN
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SLUPSKI
OtherFirstName: ERIN
OtherMiddleName: M
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: CRNP
OtherLastNameType: 1
Mailing Information
Address1: 11279 PERRY HWY
Address2: SUITE 450
City: WEXFORD
State: PA
PostalCode: 150909381
CountryCode: US
TelephoneNumber: 7249331100
FaxNumber: 7249331160
Practice Location
Address1: 4411 STILLEY RD
Address2: FIRST FLOOR
City: PITTSBURGH
State: PA
PostalCode: 152271368
CountryCode: US
TelephoneNumber: 4128827747
FaxNumber: 4128822667
Other Information
ProviderEnumerationDate: 12/06/2012
LastUpdateDate: 12/06/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XSP012581PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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