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General NPI Number Information
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NPI Number | 1760805923
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Entity Type | Individual
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Provider Name | BENJAMIN ADCOCK
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Gender | Male
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Dates
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Enumeration Date | 01/23/2014
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Last Update Date | 05/24/2021
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Provider Practice Location Address
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Address Line | 1400 LOCUST ST
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City | PITTSBURGH
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State | PA
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Zip | 15219-5114
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Country | US
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Telephone | 801-734-0737
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Fax |
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Provider Business Mailing Address
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Address Line | 517 CLEMESHA AVE
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City | PITTSBURGH
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State | PA
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Zip | 15226-2017
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Country | US
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Telephone |
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN624929
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License Number State | PA
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