Provider Demographics
NPI:1396747507
Name:ADVANCED NEPHROLOGY ASSOCIATES, P.C.
Entity type:Organization
Organization Name:ADVANCED NEPHROLOGY ASSOCIATES, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:WEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:412-766-3232
Mailing Address - Street 1:6500 BROOKTREE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9272
Mailing Address - Country:US
Mailing Address - Phone:412-766-3232
Mailing Address - Fax:412-766-4320
Practice Address - Street 1:6500 BROOKTREE RD STE 100
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9272
Practice Address - Country:US
Practice Address - Phone:412-766-3232
Practice Address - Fax:412-766-4320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207RN0300X
207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001067078009Medicaid
WV006182000Medicaid
OH0654073Medicaid
C20021Medicare ID - Type UnspecifiedRAILROAD MEDICARE
WV006182000Medicaid
OH0654073Medicaid
OH927701Medicare PIN
PA1001128Medicaid
PA478508Medicare PIN
C20021Medicare ID - Type UnspecifiedRAILROAD MEDICARE
WV0006812000Medicaid
OH0654073Medicaid