Healthcare Provider Details

I. General information

NPI: 1669437588
Provider Name (Legal Business Name): WEST PENN MEDICAL ASSOCIATES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 10/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4727 FRIENDSHIP AVE SUITE 200
PITTSBURGH PA
15224-1779
US

IV. Provider business mailing address

4727 FRIENDSHIP AVE SUITE 200
PITTSBURGH PA
15224-1779
US

V. Phone/Fax

Practice location:
  • Phone: 412-235-5810
  • Fax: 412-235-5890
Mailing address:
  • Phone: 412-235-5810
  • Fax: 412-235-5890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ELLIOT GOLDBERG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 412-235-5810