Healthcare Provider Details

I. General information

NPI: 1154930113
Provider Name (Legal Business Name): URWAT TIL VUSQA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2020
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 E NORTH AVE
PITTSBURGH PA
15212-4756
US

IV. Provider business mailing address

2 COOPER PLZ STE 3200
CAMDEN NJ
08103-1461
US

V. Phone/Fax

Practice location:
  • Phone: 412-359-3131
  • Fax:
Mailing address:
  • Phone: 856-342-2922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number25MA11674000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: