Basic Information
Provider Information
NPI: 1003152968
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARVEY
FirstName: CASEY
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 LOTHROP ST
Address2: FORBES TOWER, SUITE 9055
City: PITTSBURGH
State: PA
PostalCode: 152132536
CountryCode: US
TelephoneNumber: 4126473087
FaxNumber: 4126474486
Practice Location
Address1: 5140 LIBERTY AVE
Address2: SUITE 150
City: PITTSBURGH
State: PA
PostalCode: 152242215
CountryCode: US
TelephoneNumber: 4123150440
FaxNumber: 4123150401
Other Information
ProviderEnumerationDate: 12/21/2012
LastUpdateDate: 12/21/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XMA055877PAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


Home