Healthcare Provider Details

I. General information

NPI: 1922071406
Provider Name (Legal Business Name): PHILIP POLLICE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 04/08/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UPMC PASSAVANT PROFESSIONAL BLDG 9104 BABCOCK BLVD., SUITE 3112
PITTSBURGH PA
15237
US

IV. Provider business mailing address

9800 MCKNIGHT RD SUITE 130
PITTSBURGH PA
15237-6004
US

V. Phone/Fax

Practice location:
  • Phone: 412-366-3889
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD061605L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: