Healthcare Provider Details

I. General information

NPI: 1114999026
Provider Name (Legal Business Name): NOAH BASS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

580 S AIKEN AVE SUITE 430
PITTSBURGH PA
15232-1531
US

IV. Provider business mailing address

2 HOT METAL ST QUANTUM ONE, SUITE 001
PITTSBURGH PA
15203-2348
US

V. Phone/Fax

Practice location:
  • Phone: 412-682-2434
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD019305E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: