Healthcare Provider Details

I. General information

NPI: 1659613842
Provider Name (Legal Business Name): ALICIA H PUSKAR PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2013
Last Update Date: 02/09/2022
Certification Date: 01/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 S WATER ST
PITTSBURGH PA
15203-2307
US

IV. Provider business mailing address

PO BOX 420
PERRYOPOLIS PA
15473-0420
US

V. Phone/Fax

Practice location:
  • Phone: 412-432-3600
  • Fax: 412-432-3690
Mailing address:
  • Phone: 724-317-1647
  • Fax: 412-647-4486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS017312
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPS017312
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberPS017312
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPS017312
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: