# UPMC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** COMMUNITY MEDICINE INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1427420421
- **Legal business name:** COMMUNITY MEDICINE INC.
- **Authorized official:** TY LELLOCK (PRACTICE MANAGER)
- **Authorized official phone:** (412) 623-6910

## Contact information

- **Practice address:** 532 S AIKEN AVE, SUITE 400, PITTSBURGH, PA 15232-1521
- **Practice address phone:** (412) 623-6910
- **Practice address fax:** (412) 623-6911
- **Mailing address:** 532 S AIKEN AVE, SUITE 400, PITTSBURGH, PA 15232-1521

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | MA057919 | PA | Yes |

## Other

- **Enumeration date:** 10/29/2015
- **Last updated:** 10/29/2015