1477559854 NPI number — DR. LISA M CIBIK M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477559854 NPI number — DR. LISA M CIBIK M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

CIBIK

Provider First Name:

LISA

Provider Middle Name:

M

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1477559854

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

04/20/2008

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 644214

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:

15264-4214

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

412-653-3080

Provider Business Mailing Address Fax Number:

412-650-8963

Provider First Line Business Practice Location Address:

9970 MOUNTAIN VIEW DR

Provider Second Line Business Practice Location Address:

SUITE 200

Provider Business Practice Location Address City Name:

WEST MIFFLIN

Provider Business Practice Location Address State Name:

PA

Provider Business Practice Location Address Postal Code:

15122-2474

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

412-653-3080

Provider Business Practice Location Address Fax Number:

412-653-3580

Provider Enumeration Date:

06/22/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207W00000X , with the licence number:  MD031664E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 148344 . This is a "HIGHMARK BS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 0010885790003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
• Identifier: 0010885790008 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
• Identifier: 550151 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 1009576 . This is a "GATEWAY HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 203397 . This is a "UPMC HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 0000148344 . This is a "AMERIHEALTH ADMINISTRATOR" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 000000063863 . This is a "UNISON HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 13339 . This is a "ELDER HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 88987 . This is a "ADVANTRA/HEALTH AMERICA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: CI148344 . This is a "UMWA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".