Healthcare Provider Details

I. General information

NPI: 1497734800
Provider Name (Legal Business Name): BRIAN ERNSTOFF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 07/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5500 AYLESBORO AVE
PITTSBURGH PA
15217-1124
US

IV. Provider business mailing address

5500 AYLESBORO AVE
PITTSBURGH PA
15217-1124
US

V. Phone/Fax

Practice location:
  • Phone: 412-521-3937
  • Fax: 412-521-3937
Mailing address:
  • Phone: 412-521-3937
  • Fax: 412-521-3937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberMD036532E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: