Basic Information
| Provider Information | |||||||||
| NPI: | 1760632418 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SOUTH PITTSBURGH ANESTHESIA ASSOCIATES, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1699 WASHINGTON RD | ||||||||
| Address2: | SUITE 307 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152281629 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4128319218 | ||||||||
| FaxNumber: | 4128315663 | ||||||||
| Practice Location | |||||||||
| Address1: | 565 COAL VALLEY ROAD | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152363703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4124695000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/30/2008 | ||||||||
| LastUpdateDate: | 04/23/2009 | ||||||||
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| AuthorizedOfficialLastName: | GREGG | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
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| AuthorizedOfficialTitleorPosition: | SOLE INCORPORATOR | ||||||||
| AuthorizedOfficialTelephone: | 4128319218 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | MD030611E | PA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.