1083353767 NPI number — LESLIE KATHLEEN WALSH CYPRYCH MS, MPH

Table of content: LESLIE KATHLEEN WALSH CYPRYCH MS, MPH (NPI 1083353767)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083353767 NPI number — LESLIE KATHLEEN WALSH CYPRYCH MS, MPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CYPRYCH
Provider First Name:
LESLIE
Provider Middle Name:
KATHLEEN WALSH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, MPH
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WALSH
Provider Other First Name:
LESLIE
Provider Other Middle Name:
KATHLEEN
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:
1083353767
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/01/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4401 PENN AVE
Provider Second Line Business Mailing Address:
FACULTY PAVILION, SUITE 1000
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15224
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-692-7613
Provider Business Mailing Address Fax Number:
412-692-6472

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4401 PENN AVE
Provider Second Line Business Practice Location Address:
FACULTY PAVILION, SUITE 1000
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15224
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-692-7613
Provider Business Practice Location Address Fax Number:
412-692-6472
Provider Enumeration Date:
06/01/2022

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: 170300000X , with the licence number:  GC000406 , 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)





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