Healthcare Provider Details

I. General information

NPI: 1053739532
Provider Name (Legal Business Name): ALAN SAMUEL SLIPAK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2014
Last Update Date: 01/04/2021
Certification Date: 01/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 E NORTH AVE
PITTSBURGH PA
15212-4756
US

IV. Provider business mailing address

1307 FEDERAL ST
PITTSBURGH PA
15212-4769
US

V. Phone/Fax

Practice location:
  • Phone: 412-359-3166
  • Fax:
Mailing address:
  • Phone: 877-660-6777
  • Fax: 412-359-8055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD470719
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: