1588698864 NPI number — SANDRA L STERLITZ MPT

Table of content: SANDRA L STERLITZ MPT (NPI 1588698864)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588698864 NPI number — SANDRA L STERLITZ MPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STERLITZ
Provider First Name:
SANDRA
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NELSON
Provider Other First Name:
SANDRA
Provider Other Middle Name:
L
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1588698864
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/24/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
208 ALICIA DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEECHBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15656-8427
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-287-0711
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5230 CENTRE 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:
15232-1304
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-623-2067
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/10/2006

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: 225100000X , with the licence number:  PT008142L , 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: 251891826 . This is a "UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1585450 . This is a "HIGHMARK BC/BS OF PA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3446732 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7741595 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 251891826 . This is a "INTERGROUP SERVICES CORP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01946729 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 237320 . This is a "HEALTH AMERICA/HEALTH ASS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 001585450 . This is a "KEYSTONE HEALTH PLAN WEST" identifier . This identifiers is of the category "OTHER".




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