Basic Information
Provider Information
NPI: 1932489317
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LIKAR
FirstName: CYNTHIA
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: VISLAY
OtherFirstName: CYNTHIA
OtherMiddleName: D
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: PA-C
OtherLastNameType: 1
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: 532 S AIKEN AVE
Address2: SUITE 400
City: PITTSBURGH
State: PA
PostalCode: 152321521
CountryCode: US
TelephoneNumber: 4126236910
FaxNumber: 4126236911
Other Information
ProviderEnumerationDate: 08/17/2011
LastUpdateDate: 08/17/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XMA054977PAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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