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NPI Code Detail

MEDICARE: FULL SPECTRUM PSYCHIATRY

MEDICARE: FULL SPECTRUM PSYCHIATRY
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609481589
Entity Type Code : Organization
Provider Name (Legal Business Name) : FULL SPECTRUM PSYCHIATRY
Provider Business Mailing Address
First Line : 132 HOWARD ST
Second Line :
City : MILLVALE
State : PA
Zip : 15209-2524
Country : US
Telephone Number : 412-345-1159
Fax Number :
Provider Business Practice Location Address
First Line : 12 EASTERN AVE STE 200
Second Line :
City : PITTSBURGH
State : PA
Zip : 15215-3038
Country : US
Telephone Number : 412-345-1159
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : XENIA BORUE
Credential : MD PHD
Telephone Number : 412-345-1159
Provider Enumeration Date : 09/09/2020
Last Update Date : 07/03/2024

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Directions to “FULL SPECTRUM PSYCHIATRY ” Practice Location

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