Provider Demographics
NPI:1215985726
Name:GORSKE, TAD
Entity type:Individual
Prefix:
First Name:TAD
Middle Name:
Last Name:GORSKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 N CRAIG ST
Mailing Address - Street 2:SUITE 170
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-1571
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:155 N CRAIG ST
Practice Address - Street 2:SUITE 170
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-1571
Practice Address - Country:US
Practice Address - Phone:412-687-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS009267L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA753611OtherHIGHMARK
PA630549OtherHIGHMARK
P73085Medicare UPIN
PA064657Medicare ID - Type Unspecified