Provider Demographics
NPI:1194788083
Name:BICKET, DAPHNE P (MD)
Entity type:Individual
Prefix:DR
First Name:DAPHNE
Middle Name:P
Last Name:BICKET
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 ARDMORE BLVD. STE 700
Mailing Address - Street 2:PITTSBURGH CARE PARTNERSHIP INC.
Mailing Address - City:PGH
Mailing Address - State:PA
Mailing Address - Zip Code:15221
Mailing Address - Country:US
Mailing Address - Phone:412-436-1341
Mailing Address - Fax:412-436-1322
Practice Address - Street 1:301 MEADE ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-2131
Practice Address - Country:US
Practice Address - Phone:412-436-1298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD058307L174400000X, 207Q00000X
PAMD058307-L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PADPAO1613955Medicaid
PA161395500Medicaid
PA865022PD9Medicare PIN
PA161395500Medicaid