1114472016 NPI number — UPMC COMMUNITY MEDICINE INC

Table of content: RACHEL ELYSE BLOOM BS, RBT (NPI 1518473545)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114472016 NPI number — UPMC COMMUNITY MEDICINE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UPMC COMMUNITY MEDICINE INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

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 Information

NPI Number:
1114472016
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/20/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 HOT METAL ST
Provider Second Line Business Mailing Address:
QUANTUM ONE
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15203-2348
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-452-6395
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4381 MURRAY AVE
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:
15217-2905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-521-2857
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/20/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CALDWELL
Authorized Official First Name:
MOLLY
Authorized Official Middle Name:
Authorized Official Title or Position:
SR. MANAGER
Authorized Official Telephone Number:
412-452-6395

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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