Healthcare Provider Details

I. General information

NPI: 1760610257
Provider Name (Legal Business Name): BRITTA KOCAK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2009
Last Update Date: 06/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4221 PENN AVE SUITE 5400
PITTSBURGH PA
15224-1307
US

IV. Provider business mailing address

411 PEARL ST
PITTSBURGH PA
15224-1910
US

V. Phone/Fax

Practice location:
  • Phone: 412-692-6328
  • Fax:
Mailing address:
  • Phone: 412-897-5032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMT194907
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: