Healthcare Provider Details

I. General information

NPI: 1396631081
Provider Name (Legal Business Name): IGI OSE - TRADITIONAL BIRTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2025
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 E MCINTYRE AVE
PITTSBURGH PA
15214-3429
US

IV. Provider business mailing address

115 E MCINTYRE AVE
PITTSBURGH PA
15214-3429
US

V. Phone/Fax

Practice location:
  • Phone: 412-449-9459
  • Fax:
Mailing address:
  • Phone: 412-449-9459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175M00000X
TaxonomyLay Midwife
License Number
License Number State

VIII. Authorized Official

Name: SELENA A EISENBERG
Title or Position: COMMUNITY MIDWIFE
Credential: CM
Phone: 412-449-9459