Healthcare Provider Details

I. General information

NPI: 1336149897
Provider Name (Legal Business Name): AIMAN NASSRALLAH DAGHESTANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2005
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6321 ROUTE 30 STE 300
GREENSBURG PA
15601-9704
US

IV. Provider business mailing address

247 MOREWOOD AVE
PITTSBURGH PA
15213-1861
US

V. Phone/Fax

Practice location:
  • Phone: 724-671-1800
  • Fax: 724-523-7720
Mailing address:
  • Phone: 412-622-0290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number036056320
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036056320
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberMD030033E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: