Healthcare Provider Details

I. General information

NPI: 1811483670
Provider Name (Legal Business Name): KIRAN KURIAKOSE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2018
Last Update Date: 07/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 FIFTH AVENUE INTERNAL MEDICINE RESIDENCY PROGRAM UPMC
MCKEESPORT PA
15132
US

IV. Provider business mailing address

300 FORBES AVENUE FORBES TOWER -PLAZA LEVEL SUITE 140
PITTSBURGH PA
15213
US

V. Phone/Fax

Practice location:
  • Phone: 412-664-2395
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: