1568468205 NPI number — DR. CHARLES NEAL LEBOVITZ M. D.

Table of content: MRS. JAMIE N KAWASHITA MA, BCBA (NPI 1588291884)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568468205 NPI number — DR. CHARLES NEAL LEBOVITZ M. D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEBOVITZ
Provider First Name:
CHARLES
Provider Middle Name:
NEAL
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:
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:
1568468205
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3424 WILLIAM PENN HWY
Provider Second Line Business Mailing Address:
STE 222
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15235-5444
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-824-4660
Provider Business Mailing Address Fax Number:
412-824-4665

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3424 WILLIAM PENN HWY
Provider Second Line Business Practice Location Address:
STE 222
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15235-5444
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-824-4660
Provider Business Practice Location Address Fax Number:
412-824-4665
Provider Enumeration Date:
06/27/2005

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: 208600000X , with the licence number:  MD009553E , 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: 0007384630006 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 90947 . This is a "THREE RIVERS HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 128409 . This is a "BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 14131 . This is a "UPMC HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 001837436 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 020048162 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0007384630007 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2429465 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1019028 . This is a "GATEWAY HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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