Healthcare Provider Details

I. General information

NPI: 1255422408
Provider Name (Legal Business Name): THE CHILDRENS INSTITUTE OF PITTSBURGH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 08/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6301 NORTHUMBERLAND ST
PITTSBURGH PA
15217-1360
US

IV. Provider business mailing address

1405 SHADY AVE
PITTSBURGH PA
15217-1350
US

V. Phone/Fax

Practice location:
  • Phone: 412-420-2400
  • Fax: 412-244-3087
Mailing address:
  • Phone: 412-420-2400
  • Fax: 412-244-3087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080P0006X
TaxonomyDevelopmental - Behavioral Pediatrics Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2080P0008X
TaxonomyPediatric Neurodevelopmental Disabilities Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: WENDY PARDEE
Title or Position: PRESIDENT AND CEO
Credential:
Phone: 412-420-2209