Healthcare Provider Details

I. General information

NPI: 1487903183
Provider Name (Legal Business Name): NORTHERN ALLEGHENY PAIN MANAGEMENT CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2012
Last Update Date: 09/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5061 WILLIAM FLYNN HWY
GIBSONIA PA
15044-8442
US

IV. Provider business mailing address

5061 WILLIAM FLYNN HWY
GIBSONIA PA
15044-8442
US

V. Phone/Fax

Practice location:
  • Phone: 724-444-6811
  • Fax: 724-444-6669
Mailing address:
  • Phone: 724-444-6811
  • Fax: 724-444-6669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL M NUGENT
Title or Position: OWNER
Credential:
Phone: 724-444-6811