Healthcare Provider Details

I. General information

NPI: 1730409129
Provider Name (Legal Business Name): ALECIA RENEE HUTSLER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2010
Last Update Date: 06/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 HILAND AVE
CORAOPOLIS PA
15108-5600
US

IV. Provider business mailing address

900 HILAND AVE
CORAOPOLIS PA
15108-5600
US

V. Phone/Fax

Practice location:
  • Phone: 412-865-7839
  • Fax:
Mailing address:
  • Phone: 412-865-7839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number125058554
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: