Provider Demographics
NPI:1316946775
Name:SPINA, HORACIO (MD)
Entity type:Individual
Prefix:
First Name:HORACIO
Middle Name:
Last Name:SPINA
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 1:951 ACADEMY PL
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-2023
Mailing Address - Country:US
Mailing Address - Phone:412-561-5775
Mailing Address - Fax:412-561-2002
Practice Address - Street 1:951 ACADEMY PL
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-2023
Practice Address - Country:US
Practice Address - Phone:412-561-5775
Practice Address - Fax:412-561-2002
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2014-03-04
Deactivation Date:2006-03-18
Deactivation Code:
Reactivation Date:2006-04-03
Provider Licenses
StateLicense IDTaxonomies
PAMD034384L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA077171Medicare ID - Type Unspecified
PAB35104Medicare UPIN