Healthcare Provider Details
I. General information
NPI: 1235547282
Provider Name (Legal Business Name): LJS PSYCHIATRY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/22/2014
Last Update Date: 12/17/2023
Certification Date: 12/17/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5119 CORAL ST
PITTSBURGH PA
15224-1727
US
IV. Provider business mailing address
5119 CORAL ST
PITTSBURGH PA
15224-1727
US
V. Phone/Fax
- Phone: 412-879-0448
- Fax:
- Phone: 412-879-0448
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | MD450729 |
| License Number State | PA |
VIII. Authorized Official
Name: DR.
LOREN
J
SOBEL
Title or Position: OWNER
Credential: M.D.
Phone: 412-879-0448