Provider Demographics
NPI:1174549471
Name:BENNETT-OBRINGER PULMONARY ASSOCIATES
Entity type:Organization
Organization Name:BENNETT-OBRINGER PULMONARY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BILLOTTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-681-2103
Mailing Address - Street 1:4815 LIBERTY AVE
Mailing Address - Street 2:SUITE 456
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2156
Mailing Address - Country:US
Mailing Address - Phone:412-681-2103
Mailing Address - Fax:412-687-7194
Practice Address - Street 1:4815 LIBERTY AVE
Practice Address - Street 2:SUITE 456
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2156
Practice Address - Country:US
Practice Address - Phone:412-681-2103
Practice Address - Fax:412-687-7194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA696615Medicare ID - Type UnspecifiedGROUP ID NUMBER