Organization
CANTERBURY PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM ANTHONY NIGRO CPA (CHIEF FINANCIAL OFFICER)
(412) 864-3532
Entity
Organization
Contact information
Practice address
310 FISK ST, PITTSBURGH, PA 15201-1708
(412) 622-9000
(412) 622-9249
Mailing address
200 LOTHROP ST STE 10097, PITTSBURGH, PA 15213-2536
(412) 864-3532
(412) 864-3554
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
050702
PA
314000000X
Skilled Nursing Facility
Primary
050702
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001030200002
—
PA
01
—
0627
HIGHMARK BLUE CROSS
—
01
—
V0055A
UPMC HEALTH PLAN
—
Enumeration date
09/12/2006
Last updated
09/10/2020
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