Individual
DR. GENO JOSEPH PAVLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
310 RODI RD, SUITE 100, PITTSBURGH, PA 15235-3318
(412) 242-0777
(412) 242-5174
Mailing address
3824 NORTHERN PIKE, SUITE 700, MONROEVILLE, PA 15146-2141
(412) 457-0060
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD059655L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001651633
—
PA
01
—
080172838
RAILROAD MEDICARE
—
01
—
202461
VPMC HEALTH PLAN
—
01
—
5181567
AETNA
—
01
—
954623
BLUE SHIELD
—
01
—
P000130
GATEWAY HEALTH PLAN
—
Enumeration date
06/17/2006
Last updated
11/03/2020
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