Healthcare Provider Details

I. General information

NPI: 1104212331
Provider Name (Legal Business Name): NEHA BANSAL ETHERINGTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2015
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 LOTHROP ST # G100
PITTSBURGH PA
15213-2536
US

IV. Provider business mailing address

200 LOTHROP ST
PITTSBURGH PA
15213-2536
US

V. Phone/Fax

Practice location:
  • Phone: 412-692-4882
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD464293
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: