Healthcare Provider Details

I. General information

NPI: 1487115366
Provider Name (Legal Business Name): MARIA PUZANOV MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2019
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 SHADY AVE STE B202-2
PITTSBURGH PA
15206-4409
US

IV. Provider business mailing address

401 SHADY AVE STE B202-2
PITTSBURGH PA
15206-4409
US

V. Phone/Fax

Practice location:
  • Phone: 412-312-3178
  • Fax:
Mailing address:
  • Phone: 412-312-3178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD480928
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: