MEDICARE: MRS. THERESE IRENE DENINNO PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	MA050686	PA

General Provider Information

NPI Number	:	1487644530
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. THERESE IRENE DENINNO PA-C

Provider Business Mailing Address
First Line	:	120 5TH AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15222-3000
Country	:	US
Telephone Number	:	412-427-3390
Fax Number	:	844-978-2756

Provider Business Practice Location Address
First Line	:	120 5TH AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15222-3000
Country	:	US
Telephone Number	:	412-427-3390
Fax Number	:	844-978-2756

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2005
Last Update Date	:	10/28/2024

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