Healthcare Provider Details

I. General information

NPI: 1821900424
Provider Name (Legal Business Name): COLAIZZI PEDORTHIC CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

452 MOON CLINTON RD
MOON TOWNSHIP PA
15108-3824
US

IV. Provider business mailing address

107 MOUNT NEBO POINTE RD STE 102
PITTSBURGH PA
15237-1315
US

V. Phone/Fax

Practice location:
  • Phone: 412-748-0252
  • Fax: 412-748-0259
Mailing address:
  • Phone: 412-748-0252
  • Fax: 412-748-0259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: GEORGE KOWATIC
Title or Position: PRESIDENT
Credential:
Phone: 412-748-0252