Provider Demographics
NPI:1245326495
Name:SZABO, BRIAN (DPM)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:SZABO
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 SHENANGO VALLEY FWY
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-2536
Mailing Address - Country:US
Mailing Address - Phone:724-981-1141
Mailing Address - Fax:724-981-1658
Practice Address - Street 1:2501 SHENANGO VALLEY FWY
Practice Address - Street 2:SUITE 2
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-2536
Practice Address - Country:US
Practice Address - Phone:724-981-1141
Practice Address - Fax:724-981-1658
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2008-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002909L213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010471460004Medicaid
PA0010471460004Medicaid
PAT29590Medicare UPIN
PA145689ZARQMedicare PIN