Healthcare Provider Details

I. General information

NPI: 1952312399
Provider Name (Legal Business Name): ZITELLI & BRODLAND PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 05/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 COAL VALLEY ROAD SUITE 360
CLAIRTON PA
15025
US

IV. Provider business mailing address

575 COAL VALLEY ROAD SUITE 360
CLAIRTON PA
15025
US

V. Phone/Fax

Practice location:
  • Phone: 412-466-9400
  • Fax: 412-460-0322
Mailing address:
  • Phone: 412-466-9400
  • Fax: 412-460-0322

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number09381500
License Number StatePA

VIII. Authorized Official

Name: JOHN A ZITELLI
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 412-681-9400