Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | SC002673L | PA |
Y | 222Z00000X | Podiatrist | SC002673L | PA |
NPI | 1013098615 |
---|---|
Provider Name | Alvin J Wostein |
First Address | Pittsburgh, PA 15203-1930 |
Second Address | Pittsburgh, PA 15217-1657 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 28/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0009633870004 | (05) | PA |
T30462 | (02) | PA |