1447473632 NPI number — UPMC WASHINGTON

Table of content: SUSAN ELAINE REICHENBERGER OTR (NPI 1386709442)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447473632 NPI number — UPMC WASHINGTON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UPMC WASHINGTON
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:
6
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:
1447473632
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/20/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
95 LEONARD AVE
Provider Second Line Business Mailing Address:
BLDG 2 THIRD FLOOR
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15301-3368
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-223-3256
Provider Business Mailing Address Fax Number:
724-229-2379

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
95 LEONARD AVE
Provider Second Line Business Practice Location Address:
BLDG 2 THIRD FLOOR
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15301-3368
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-223-3256
Provider Business Practice Location Address Fax Number:
724-229-2379
Provider Enumeration Date:
04/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
O'BRIEN
Authorized Official First Name:
LAUREN
Authorized Official Middle Name:
K
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
724-223-3548

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  230201 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1501525 . This is a "UPMC FOR YOU" identifier , issued by the state of ( PW ) . This identifiers is of the category "OTHER".
  • Identifier: 1007389110130 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1011734 . This is a "GATEWAY" identifier , issued by the state of ( PW ) . This identifiers is of the category "OTHER".
  • Identifier: 65681 . This is a "UNISON" identifier , issued by the state of ( PW ) . This identifiers is of the category "OTHER".




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