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5655 Bryant St # 205 Pittsburgh PA 15206-1511 | |
| (412) 551-4274 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 5655 Bryant St # 205, Pittsburgh, Pennsylvania |
| Authorized Official Name and Position | Benjmain Fisher (PRESIDENT) |
| Authorized Official Contact | 4125514274 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
5655 Bryant St Ste 205 Pittsburgh PA 15206-1511 Ph: () - | 5655 Bryant St # 205 Pittsburgh PA 15206-1511 Ph: (412) 551-4274 |
| NPI Number | 1538902135 |
|---|---|
| Provider Enumeration Date | 06/13/2024 |
| Last Update Date | 01/30/2025 |
| Certification Date | 01/30/2025 |
| Medicare PECOS PAC ID | 3072044023 |
|---|---|
| Medicare Enrollment ID | O20241002000880 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538902135 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Benjamin R Fisher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114268828 PECOS PAC ID: 3971856469 Enrollment ID: I20181031000550 |
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