Provider Demographics
NPI:1033108402
Name:COLAIACO, PAUL A (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:A
Last Name:COLAIACO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 REEDSDALE ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15233-2109
Mailing Address - Country:US
Mailing Address - Phone:412-323-4543
Mailing Address - Fax:412-323-4507
Practice Address - Street 1:412 E COMMONS
Practice Address - Street 2:EAST COMMONS CENTER
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-5310
Practice Address - Country:US
Practice Address - Phone:412-442-1900
Practice Address - Fax:412-442-1901
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD030866E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA128475OtherHIGHMARK
PA0990624Medicaid
PA128475OtherHIGHMARK
C31059Medicare UPIN