Provider Demographics
NPI:1164623633
Name:SIALA, TAREK M (PA-C)
Entity type:Individual
Prefix:
First Name:TAREK
Middle Name:M
Last Name:SIALA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 LOCUST ST STE 2100
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-5114
Mailing Address - Country:US
Mailing Address - Phone:412-232-3687
Mailing Address - Fax:412-232-8488
Practice Address - Street 1:1400 LOCUST ST STE 2100
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15219-5114
Practice Address - Country:US
Practice Address - Phone:412-232-3687
Practice Address - Fax:412-232-8488
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA066528363AM0700X
NY015149363AM0700X
MAPA3914363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400067274Medicare PIN