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General NPI Number Information
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NPI Number | 1588030340
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Entity Type | Individual
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Provider Name | NIKOLAI LIARTIS
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Gender | Male
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Dates
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Enumeration Date | 08/17/2015
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Last Update Date | 08/17/2015
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Provider Practice Location Address
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Address Line | 1350 LOCUST ST
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City | PITTSBURGH
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State | PA
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Zip | 15219-4738
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Country | US
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Telephone | 412-471-4772
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Fax |
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Provider Business Mailing Address
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Address Line | 1190 HULTON RD
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City | OAKMONT
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State | PA
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Zip | 15139-1134
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Country | US
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Telephone | 412-443-0752
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP015112
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License Number State | PA
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