Provider Demographics
NPI:1427270594
Name:ST CLAIR PROFESSIONAL SERVICES INC
Entity type:Organization
Organization Name:ST CLAIR PROFESSIONAL SERVICES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:PAMALYN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATNESKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-942-2548
Mailing Address - Street 1:1000 BOWER HILL RD
Mailing Address - Street 2:ST CLAIR HOSPITAL - AFFILIATE BILLING - PAMALYN
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1873
Mailing Address - Country:US
Mailing Address - Phone:412-942-4000
Mailing Address - Fax:
Practice Address - Street 1:1000 BOWER HILL RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1873
Practice Address - Country:US
Practice Address - Phone:412-942-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. CLAIR HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-02
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1872706OtherHIGHMARK BLUE SHIELD PEDIATRIC
PA1872714OtherHIGHMARK BLUE SHIELD CRITICAL CARE
PA1872720OtherHIGHMARK BLUE SHIELD HOUSE
PA1872720OtherHIGHMARK BLUE SHIELD HOUSE