Healthcare Provider Details

I. General information

NPI: 1356334759
Provider Name (Legal Business Name): NORTH SHORE ENDOSCOPY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1307 FEDERAL ST SUITE 101
PITTSBURGH PA
15212-4705
US

IV. Provider business mailing address

1307 FEDERAL ST SUITE 101
PITTSBURGH PA
15212-4705
US

V. Phone/Fax

Practice location:
  • Phone: 412-231-6550
  • Fax: 412-231-6697
Mailing address:
  • Phone: 412-231-6550
  • Fax: 412-231-6697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number15901501
License Number StatePA

VIII. Authorized Official

Name: MS. ROBIN LAPORTE
Title or Position: MANAGER
Credential:
Phone: 412-359-8975