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NPI Code Detail

MEDICARE: DR. RANDY PAUL TABITA D.C.

MEDICARE: DR. RANDY PAUL TABITA D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractorCHIR008523GA
2111N00000XChiropractorDC010194PA

General Provider Information

NPI Number : 1285866566
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RANDY PAUL TABITA D.C.
Provider Business Mailing Address
First Line : 1927 E CARSON ST
Second Line :
City : PITTSBURGH
State : PA
Zip : 15203-1835
Country : US
Telephone Number : 412-381-4422
Fax Number : 412-281-8503
Provider Business Practice Location Address
First Line : 1927 E CARSON ST
Second Line :
City : PITTSBURGH
State : PA
Zip : 15203-1835
Country : US
Telephone Number : 412-381-4422
Fax Number : 412-281-8503
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2009
Last Update Date : 11/18/2009

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