Individual
VITASTA BAZAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD MPH
Contact information
Practice address
2100 JANE ST, STE 210, PITTSBURGH, PA 15203-2065
(412) 488-1880
(412) 488-8216
Mailing address
2100 JANE ST, STE 210, PITTSBURGH, PA 15203-2065
(412) 488-1880
(412) 488-8216
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD035564-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00848204
—
PA
Enumeration date
11/14/2005
Last updated
07/08/2007
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