MEDICARE: DR. JAMI DIAMOND PINCAVITCH MD

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
1	208000000X	Pediatrics Physician	MD418743	PA
2	207R00000X	Internal Medicine Physician	MD418743	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	10923424	OTHER	PA	AETNA
2	136496	OTHER	PA	THREE RIVERS
3	1393136	OTHER	PA	BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	312927	OTHER	PA	UPMC
6	P004715	OTHER	PA	GATEWAY

General Provider Information

NPI Number	:	1598769465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMI DIAMOND PINCAVITCH MD

Provider Business Mailing Address
First Line	:	350 BONAR AVENUE
Second Line	:
City	:	WAYNESBURG
State	:	PA
Zip	:	15370
Country	:	US
Telephone Number	:	724-627-3101
Fax Number	:	724-627-7639

Provider Business Practice Location Address
First Line	:	350 BONAR AVENUE
Second Line	:
City	:	WAYNESBURG
State	:	PA
Zip	:	15370
Country	:	US
Telephone Number	:	724-627-3101
Fax Number	:	724-627-7639

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	01/13/2021

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