Healthcare Provider Details

I. General information

NPI: 1023084472
Provider Name (Legal Business Name): DEBRA WEINER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 03/25/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5750 CENTRE AVE SUITE 400
PITTSBURGH PA
15206-3721
US

IV. Provider business mailing address

5750 CENTRE AVE SUITE 400
PITTSBURGH PA
15206-3721
US

V. Phone/Fax

Practice location:
  • Phone: 412-655-8030
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberMD064602L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: