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General NPI Number Information
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NPI Number | 1801647722
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Entity Type | Individual
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Provider Name | LISA ANN GUBISH PTA
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Gender | Female
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Dates
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Enumeration Date | 03/28/2024
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | 110 MCINTYRE RD
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City | PITTSBURGH
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State | PA
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Zip | 15237-7305
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Country | US
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Telephone | 412-369-2123
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Fax |
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Provider Business Mailing Address
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Address Line | 710 TIMBER LN
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City | SEWICKLEY
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State | PA
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Zip | 15143-8959
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Country | US
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Telephone | 412-445-6762
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | TE1000860
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License Number State | PA
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