Healthcare Provider Details

I. General information

NPI: 1265726590
Provider Name (Legal Business Name): ASSOCIATES IN QUALITY PSYCIATRIC MEDICINE P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2011
Last Update Date: 06/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4416 PENN AVE
PITTSBURGH PA
15224-1312
US

IV. Provider business mailing address

4416 PENN AVE
PITTSBURGH PA
15224-1312
US

V. Phone/Fax

Practice location:
  • Phone: 412-681-2211
  • Fax: 412-687-0728
Mailing address:
  • Phone: 412-681-2211
  • Fax: 412-687-0728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY S. MITZEL
Title or Position: PSYCHIATRIST
Credential: D.O.
Phone: 412-681-2211