Organization
GERIATRIC PSYCHOLOGICAL ASSOCIATE INC
Active
Organization
GERIATRIC PSYCHOLOGICAL ASSOCIATE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WAYNE ANTHONY HOOVER PHD (CHIEF EXECUTIVE OFFICER)
41278223510
Entity
Organization
Contact information
Practice address
122 EMERSON AVE, PITTSBURGH, PA 15215-3208
(412) 782-3510
(412) 782-6860
Mailing address
122 EMERSON AVE, PITTSBURGH, PA 15215-3208
(412) 782-3510
(412) 782-6860
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
001741210
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001741210
BCBS
PA
05
—
101839230
—
PA
Enumeration date
05/11/2006
Last updated
04/04/2017
Update your record
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