Provider Demographics
NPI:1215482732
Name:MEDER, CAROLYN
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:MEDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6693 KINSMAN RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15217-1359
Mailing Address - Country:US
Mailing Address - Phone:412-977-0121
Mailing Address - Fax:
Practice Address - Street 1:1555 CENTRAL PKWY
Practice Address - Street 2:MERCY HEALTH
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45214
Practice Address - Country:US
Practice Address - Phone:412-977-0121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-25
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer