Healthcare Provider Details

I. General information

NPI: 1295962546
Provider Name (Legal Business Name): JOSE F ABAD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2009
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5608 WILKINS AVE STE 100
PITTSBURGH PA
15217-1282
US

IV. Provider business mailing address

20630 ROUTE 19 UNIT 101
CRANBERRY TOWNSHIP PA
16066-6021
US

V. Phone/Fax

Practice location:
  • Phone: 412-422-8762
  • Fax:
Mailing address:
  • Phone: 724-779-2273
  • Fax: 724-779-3006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA113902
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD0472577
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: