Healthcare Provider Details

I. General information

NPI: 1407821945
Provider Name (Legal Business Name): PAUL A PILKONIS PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2006
Last Update Date: 12/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3811 O'HARA STREET SUITE 1135-E
PITTSBURGH PA
15213
US

IV. Provider business mailing address

200 LOTHROP STREET SUITE 9055, FORBES TOWER
PITTSBURGH PA
15213-2536
US

V. Phone/Fax

Practice location:
  • Phone: 412-624-1000
  • Fax:
Mailing address:
  • Phone: 412-647-3087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberPS003175L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS003175L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: