Healthcare Provider Details

I. General information

NPI: 1639144256
Provider Name (Legal Business Name): JOHN OZOLEK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 04/08/2022
Certification Date: 04/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 PENN AVE
PITTSBURGH PA
15224-1334
US

IV. Provider business mailing address

4401 PENN AVENUE
PITTSBURGH PA
15224
US

V. Phone/Fax

Practice location:
  • Phone: 412-692-5650
  • Fax:
Mailing address:
  • Phone: 412-692-5650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0213X
TaxonomyPediatric Pathology Physician
License NumberMD046799L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: