1073891412 NPI number — DR. OMAYA IBRAHIM BANIHANI M.D.

Table of content: (NPI 1538328414)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073891412 NPI number — DR. OMAYA IBRAHIM BANIHANI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BANIHANI
Provider First Name:
OMAYA
Provider Middle Name:
IBRAHIM
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BANIHANI
Provider Other First Name:
OMAYA
Provider Other Middle Name:
IBRAHIM
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1073891412
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/17/2012
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:
CHILDREN HOSPITAL OF PITTSBURGH
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15224-1334
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-377-5866
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 OAK HILL DRIVE
Provider Second Line Business Practice Location Address:
APT 202
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-377-5866
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/03/2011

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: 2088P0231X , with the licence number:  MT202414 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 390200000X , with the licence number: C7-0004880 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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