Healthcare Provider Details

I. General information

NPI: 1770644072
Provider Name (Legal Business Name): VETERANS AFFAIRS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2941 MATTERN AVE
PITTSBURGH PA
15216
US

IV. Provider business mailing address

2941 MATTERN AVE
PITTSBURGH PA
15216
US

V. Phone/Fax

Practice location:
  • Phone: 412-344-4915
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License NumberRN290407L
License Number StatePA

VIII. Authorized Official

Name: JOHN MITRO
Title or Position: RN SUPERVISOR
Credential: RN
Phone: 412-688-6000