Healthcare Provider Details

I. General information

NPI: 1629028196
Provider Name (Legal Business Name): MARK SBARRO DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 05/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 HOT METAL ST ERMI QUANTUM ONE
PITTSBURGH PA
15203-2348
US

IV. Provider business mailing address

2 HOT METAL ST ERMI QUANTUM ONE
PITTSBURGH PA
15203-2348
US

V. Phone/Fax

Practice location:
  • Phone: 412-432-7424
  • Fax:
Mailing address:
  • Phone: 412-432-7424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOS008280L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberOS8663
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: