Healthcare Provider Details

I. General information

NPI: 1740689637
Provider Name (Legal Business Name): PAMELA SCHANG PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2014
Last Update Date: 08/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 CORAOPOLIS RD
CORAOPOLIS PA
15108-4004
US

IV. Provider business mailing address

234 CORAOPOLIS RD
CORAOPOLIS PA
15108-4004
US

V. Phone/Fax

Practice location:
  • Phone: 412-331-6060
  • Fax: 412-331-1228
Mailing address:
  • Phone: 412-331-6060
  • Fax: 412-331-1228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberTE1000836
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberTE1000836
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: