Provider Demographics
NPI:1306964051
Name:PITTSBURGH REGIONAL CHIROPRACTIC CENTER
Entity type:Organization
Organization Name:PITTSBURGH REGIONAL CHIROPRACTIC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:STRUSS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-761-4800
Mailing Address - Street 1:PO BOX 4166
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15202
Mailing Address - Country:US
Mailing Address - Phone:412-761-8877
Mailing Address - Fax:412-761-8855
Practice Address - Street 1:553 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:PA
Practice Address - Zip Code:15202-3531
Practice Address - Country:US
Practice Address - Phone:724-761-4800
Practice Address - Fax:412-761-8855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-007619-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100949747000Medicaid
PA100949747000Medicaid
U80779Medicare UPIN