Healthcare Provider Details

I. General information

NPI: 1336444819
Provider Name (Legal Business Name): STEVEN FICKNER PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2011
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 QUINN DR STE 160
PITTSBURGH PA
15275-1055
US

IV. Provider business mailing address

200 QUINN DR STE 160
PITTSBURGH PA
15275-1055
US

V. Phone/Fax

Practice location:
  • Phone: 412-722-1003
  • Fax: 412-722-1385
Mailing address:
  • Phone: 412-722-1003
  • Fax: 412-722-1385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA054738
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: