Healthcare Provider Details

I. General information

NPI: 1235125584
Provider Name (Legal Business Name): AMY P HURSH D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY E PAIVA

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 11/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2541 E. CARSON ST.
PITTSBURGH PA
15203
US

IV. Provider business mailing address

2541 E. CARSON ST.
PITTSBURGH PA
15203
US

V. Phone/Fax

Practice location:
  • Phone: 412-432-7909
  • Fax: 412-202-2304
Mailing address:
  • Phone: 412-432-7909
  • Fax: 412-202-2304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License NumberOS010313L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: