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Organization

UPMC BRADDOCK

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SUSAN MAMMARELLA CFO (CFO)
(412) 636-5314
Entity
Organization

Contact information

Practice address
200 LOTHROP ST, QUANTUM #1 3RD FL, PITTSBURGH, PA 15213-2536
(412) 432-5500
Mailing address
400 HOLLAND AVE, BRADDOCK, PA 15104-1599
(412) 432-5500

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0002
HIGHMARK PROVIDER NUMBER
PA
Enumeration date
12/21/2006
Last updated
12/31/2007
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