Healthcare Provider Details

I. General information

NPI: 1063466233
Provider Name (Legal Business Name): ZUCKERMAN FAMILY PRACTICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 BALDWICK RD
PITTSBURGH PA
15205-4140
US

IV. Provider business mailing address

2500 BALDWICK RD
PITTSBURGH PA
15205-4140
US

V. Phone/Fax

Practice location:
  • Phone: 412-922-6262
  • Fax: 412-922-5026
Mailing address:
  • Phone: 412-922-6262
  • Fax: 412-922-5026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MYLES H ZUCKERMAN
Title or Position: CO-OWNER
Credential: M.D.
Phone: 412-922-6262