Provider Demographics
NPI:1588741003
Name:MARIA J. SUNSERI, M.D. L.L.C.
Entity type:Organization
Organization Name:MARIA J. SUNSERI, M.D. L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:SUNSERI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-781-2023
Mailing Address - Street 1:4815 LIBERTY AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2156
Mailing Address - Country:US
Mailing Address - Phone:412-781-2023
Mailing Address - Fax:412-727-7842
Practice Address - Street 1:4815 LIBERTY AVE
Practice Address - Street 2:STE M-02
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2156
Practice Address - Country:US
Practice Address - Phone:412-781-2023
Practice Address - Fax:412-727-7842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2019-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 047961L2084N0400X, 2084S0012X
MA2168492084N0400X, 2084N0600X, 2084S0012X
PAMD 047961 L2084N0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Single Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical NeurophysiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA9088664OtherAETNA
PATINOtherCIGNA
PA271227OtherMEDICARE PTAN
PA1028450170001Medicaid
PA1492414OtherHIGHMARK BLUE SHIELD
PA227451OtherCOVENTRY (HAM, HA, ADV, COV CARES)
PA1539350OtherGATEWAY HEALTH PLAN