Healthcare Provider Details

I. General information

NPI: 1053433763
Provider Name (Legal Business Name): PITTSBURGH HOLISTIC NETWORK EAST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 01/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4318 NORTHERN PIKE SUITE 101
MONROEVILLE PA
15146-2809
US

IV. Provider business mailing address

4318 NORTHERN PIKE SUITE 101
MONROEVILLE PA
15146-2809
US

V. Phone/Fax

Practice location:
  • Phone: 412-856-2281
  • Fax: 412-856-2932
Mailing address:
  • Phone: 412-856-2281
  • Fax: 412-856-2932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202C00000X
TaxonomyIndependent Medical Examiner Physician
License NumberMD038265L
License Number StatePA

VIII. Authorized Official

Name: DR. MEHERNOSH PHEROZE KHAN
Title or Position: PRESIDENT
Credential: MD
Phone: 412-856-2281