Healthcare Provider Details

I. General information

NPI: 1700231669
Provider Name (Legal Business Name): GREATER PITTSBURGH ORTHOPAEDIC ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2016
Last Update Date: 02/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 EMERYVILLE DR BUSH CREEK COMMONS, SUITE 130
CRANBERRY TOWNSHIP PA
16066-5015
US

IV. Provider business mailing address

5820 CENTRE AVE
PITTSBURGH PA
15206-3710
US

V. Phone/Fax

Practice location:
  • Phone: 724-772-5250
  • Fax: 724-772-2838
Mailing address:
  • Phone: 412-661-6484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0006606000001
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name: CHRISTOPHER KOLIC
Title or Position: CEO
Credential:
Phone: 412-661-6484