Healthcare Provider Details

I. General information

NPI: 1194789933
Provider Name (Legal Business Name): RANDALL HUZINEC PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2006
Last Update Date: 03/23/2021
Certification Date: 03/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 MARY ST
PITTSBURGH PA
15203-2054
US

IV. Provider business mailing address

8112 WESTERN ST
ELLWOOD CITY PA
16117
US

V. Phone/Fax

Practice location:
  • Phone: 412-488-5898
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT006518L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: