Provider Demographics
NPI:1548246457
Name:PESACRETA, MATTHEW G (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:G
Last Name:PESACRETA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2242 DARLINGTON RD
Mailing Address - Street 2:UNIT B
Mailing Address - City:BEAVER FALLS
Mailing Address - State:PA
Mailing Address - Zip Code:15010-1329
Mailing Address - Country:US
Mailing Address - Phone:724-384-8392
Mailing Address - Fax:724-384-0066
Practice Address - Street 1:1597 WASHINGTON PIKE
Practice Address - Street 2:SUITE A-22
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-2894
Practice Address - Country:US
Practice Address - Phone:412-489-6919
Practice Address - Fax:412-489-6279
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2015-02-17
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Provider Licenses
StateLicense IDTaxonomies
PAMD0418075207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1010379010001Medicaid
PA1010379010001Medicaid
PAI006652Medicare UPIN