Healthcare Provider Details

I. General information

NPI: 1063833317
Provider Name (Legal Business Name): CHS NY MEDICAL, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2014
Last Update Date: 01/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 GRANT ST SUITE 151-2010
PITTSBURGH PA
15219-2502
US

IV. Provider business mailing address

500 GRANT ST SUITE 151-2010
PITTSBURGH PA
15219-2502
US

V. Phone/Fax

Practice location:
  • Phone: 412-234-4500
  • Fax: 412-234-5500
Mailing address:
  • Phone: 412-234-4500
  • Fax: 412-234-5500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1800X
TaxonomyCorporate Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NIKKEE FINLEY
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 843-769-7633