Healthcare Provider Details

I. General information

NPI: 1255367744
Provider Name (Legal Business Name): PLASTIC SURGICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4815 LIBERTY AVE SUITE 235
PITTSBURGH PA
15224-2156
US

IV. Provider business mailing address

PO BOX 1961
PITTSBURGH PA
15230-1961
US

V. Phone/Fax

Practice location:
  • Phone: 412-681-5995
  • Fax: 412-681-5772
Mailing address:
  • Phone: 412-826-1065
  • Fax: 412-826-1491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: E DOUGLAS NEWTON
Title or Position: PHYSICIAN
Credential: MD
Phone: 412-681-5995