1235125584 NPI number — MRS. AMY P HURSH D.O.

Table of content: MRS. AMY P HURSH D.O. (NPI 1235125584)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235125584 NPI number — MRS. AMY P HURSH D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HURSH
Provider First Name:
AMY
Provider Middle Name:
P
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PAIVA
Provider Other First Name:
AMY
Provider Other Middle Name:
E
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1235125584
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/14/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2541 E. CARSON ST.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15203
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-432-7909
Provider Business Mailing Address Fax Number:
412-202-2304

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2541 E. CARSON ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-432-7909
Provider Business Practice Location Address Fax Number:
412-202-2304
Provider Enumeration Date:
09/22/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207QA0000X , with the licence number:  OS010313L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)