1801832134 NPI number — LINDA ROBERTS MD

Table of content: LINDA ROBERTS MD (NPI 1801832134)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801832134 NPI number — LINDA ROBERTS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBERTS
Provider First Name:
LINDA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PALONE
Provider Other First Name:
LINDA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1801832134
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/19/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
580 S AIKEN AVE
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15232-1531
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-687-5040
Provider Business Mailing Address Fax Number:
412-682-1940

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
580 S AIKEN AVE
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15232-1531
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-687-5040
Provider Business Practice Location Address Fax Number:
412-682-1940
Provider Enumeration Date:
06/22/2006

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: 207R00000X , with the licence number:  MD014681E , 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)

  • Identifier: 0662534 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0179 . This is a "UNIVERSITY PITTSBURGH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".