Healthcare Provider Details

I. General information

NPI: 1407306566
Provider Name (Legal Business Name): GREATER PITTSBURGH ORTHOPAEDIC ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2016
Last Update Date: 10/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 BROWNSVILLE RD SUITE C
PITTSBURGH PA
15227-2469
US

IV. Provider business mailing address

5820 CENTRE AVE
PITTSBURGH PA
15206-3710
US

V. Phone/Fax

Practice location:
  • Phone: 412-884-2733
  • Fax:
Mailing address:
  • Phone: 412-661-6484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StatePA

VIII. Authorized Official

Name: MR. CHRISTOPHER KOLIC
Title or Position: CEO
Credential:
Phone: 412-661-6484