Provider Demographics
NPI:1902807274
Name:PUSATERI, DOROTHY W (MD)
Entity Type:Individual
Prefix:DR
First Name:DOROTHY
Middle Name:W
Last Name:PUSATERI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DOROTHY
Other - Middle Name:FRANCES
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:320 E NORTH AVE
Mailing Address - Street 2:2ND FL
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4756
Mailing Address - Country:US
Mailing Address - Phone:412-359-3030
Mailing Address - Fax:412-359-3060
Practice Address - Street 1:320 E NORTH AVE
Practice Address - Street 2:2ND FL
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4756
Practice Address - Country:US
Practice Address - Phone:412-359-3030
Practice Address - Fax:412-359-3060
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD037194E207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011566500011Medicaid
PAE52892Medicare UPIN
PA545363Medicare PIN
PA110242934Medicare PIN
PA0011566500011Medicaid