Basic Information
Provider Information
NPI: 1679564371
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OCZYPOK
FirstName: PAUL
MiddleName: MARK
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 WALSH RD
Address2: CRAFTON INGRAM SHOP CTR CRAFTON MEDICAL CENTER
City: PITTSBURGH
State: PA
PostalCode: 152052336
CountryCode: US
TelephoneNumber: 4129223773
FaxNumber: 4129226093
Practice Location
Address1: 1 WALSH RD
Address2: CRAFTON INGRAM SHOP CTR CRAFTON MEDICAL CENTER
City: PITTSBURGH
State: PA
PostalCode: 152052336
CountryCode: US
TelephoneNumber: 4129223773
FaxNumber: 4129226093
Other Information
ProviderEnumerationDate: 11/02/2005
LastUpdateDate: 10/07/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/07/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMD030129PAY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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