Healthcare Provider Details

I. General information

NPI: 1265940811
Provider Name (Legal Business Name): ELISE BOCHKORIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2018
Last Update Date: 06/15/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HALKET ST 3RD FLOOR ROOM 3510
PITTSBURGH PA
15213-3108
US

IV. Provider business mailing address

271 38TH ST
PITTSBURGH PA
15201-1853
US

V. Phone/Fax

Practice location:
  • Phone: 412-641-4260
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number120747
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: