Healthcare Provider Details

I. General information

NPI: 1780643650
Provider Name (Legal Business Name): ANTHONY J PINEVICH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 03/03/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 LOCUST ST
PITTSBURGH PA
15219-5114
US

IV. Provider business mailing address

PO BOX 321
INGOMAR PA
15127-0321
US

V. Phone/Fax

Practice location:
  • Phone: 412-478-5360
  • Fax: 724-522-5142
Mailing address:
  • Phone: 412-478-5360
  • Fax: 724-522-5142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD037574E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD037574E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: