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General NPI Number Information
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NPI Number | 1790660496
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Entity Type | Individual
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Provider Name | MITCHELL BERRY
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Gender | Male
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Dates
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Enumeration Date | 08/11/2025
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 1622 LOCUST ST
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City | PITTSBURGH
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State | PA
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Zip | 15219-5924
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Country | US
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Telephone | 336-413-9313
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Fax |
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Provider Business Mailing Address
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Address Line | 147 39TH ST APT 257
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City | PITTSBURGH
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State | PA
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Zip | 15201-3295
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Country | US
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Telephone | 336-413-9313
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT033520
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License Number State | PA
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