1669565859 NPI number — JEFFREY GUY RUSCITTO D.C.

Table of content: (NPI 1629287859)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669565859 NPI number — JEFFREY GUY RUSCITTO D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RUSCITTO
Provider First Name:
JEFFREY
Provider Middle Name:
GUY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

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:
1669565859
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/13/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5400 KEEPORT DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15236-3006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-655-8171
Provider Business Mailing Address Fax Number:
412-655-7232

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5400 KEEPORT DR
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:
15236-3006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-655-8171
Provider Business Practice Location Address Fax Number:
412-655-7232
Provider Enumeration Date:
10/02/2006

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: 111N00000X , with the licence number:  DC005301L , 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: 409534 . This is a "HEALTH AMERICA" identifier . This identifiers is of the category "OTHER".
  • Identifier: RU739138 . This is a "BLUE CROSS/BLUESHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 251741468 . This is a "DEVON" identifier . This identifiers is of the category "OTHER".
  • Identifier: 650526 . This is a "ACN GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 310901 . This is a "UPMC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 11026326 . This is a "CAQH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01882363 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 251741468 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 409534 . This is a "HEALTH ASSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1020542 . This is a "AMERICAN SPECIALTY HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1605006001 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".




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