Provider Demographics
NPI:1285609552
Name:SCLABASSI, ROBERT J (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:SCLABASSI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 BAUM BLVD
Mailing Address - Street 2:SUITE 530
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-1853
Mailing Address - Country:US
Mailing Address - Phone:412-681-9990
Mailing Address - Fax:
Practice Address - Street 1:5001 BAUM BLVD
Practice Address - Street 2:SUITE 530
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-1853
Practice Address - Country:US
Practice Address - Phone:412-681-9990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD064935L174400000X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001602254Medicaid
PA001602254Medicaid
PA892861FKCMedicare PIN
PAG35584Medicare UPIN