Healthcare Provider Details

I. General information

NPI: 1942526314
Provider Name (Legal Business Name): KIDS PLUS PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2010
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 CLAIRTON BLVD
PITTSBURGH PA
15236-4567
US

IV. Provider business mailing address

810 CLAIRTON BLVD
PITTSBURGH PA
15236-4567
US

V. Phone/Fax

Practice location:
  • Phone: 412-466-5004
  • Fax: 412-466-7137
Mailing address:
  • Phone: 412-466-5004
  • Fax: 412-466-7137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number069625-L
License Number StatePA

VIII. Authorized Official

Name: DR. ALBERT WOLF
Title or Position: OWNER
Credential: MD
Phone: 412-466-5004