Healthcare Provider Details

I. General information

NPI: 1447204128
Provider Name (Legal Business Name): VASCULAR ACCESS CENTER OF PITTSBURGH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 05/26/2020
Certification Date: 05/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 DUTILH RD STE 100
CRANBERRY TOWNSHIP PA
16066-4148
US

IV. Provider business mailing address

2929 ARCH STREET SUITE 1705
PHILADELPHIA PA
19104-2866
US

V. Phone/Fax

Practice location:
  • Phone: 412-683-4504
  • Fax: 412-383-4505
Mailing address:
  • Phone: 215-382-3680
  • Fax: 215-401-6772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number StatePA

VIII. Authorized Official

Name: MR. SETH SHARPE
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 215-382-3680