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NPI Code Detail

MEDICARE: RENAISSANCE FAMILY PRACTICE, INC

MEDICARE: RENAISSANCE FAMILY PRACTICE, INC
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
1207Q00000XFamily Medicine Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1894920OTHERPAHIGHMARK DIVISION

General Provider Information

NPI Number : 1487689154
Entity Type Code : Organization
Provider Name (Legal Business Name) : RENAISSANCE FAMILY PRACTICE, INC
Provider Business Mailing Address
First Line : 600 WATERCREST WAY
Second Line : SUITE 630
City : CHESWICK
State : PA
Zip : 15024-1370
Country : US
Telephone Number : 724-274-9420
Fax Number : 724-274-9370
Provider Business Practice Location Address
First Line : 1748 JANCEY ST
Second Line :
City : PITTSBURGH
State : PA
Zip : 15206-1100
Country : US
Telephone Number : 412-661-1993
Fax Number : 412-661-2829
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MARIE ZANOTTI
Credential :
Telephone Number : 724-274-9451
Provider Enumeration Date : 07/11/2006
Last Update Date : 08/22/2020

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Directions to “RENAISSANCE FAMILY PRACTICE, INC ” Practice Location

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