Healthcare Provider Details

I. General information

NPI: 1164469375
Provider Name (Legal Business Name): ALEXANDRE DOMBROVSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 12/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 RODI RD
PENN HILLS PA
15235-4564
US

IV. Provider business mailing address

645 RODI RD STE 200
PENN HILLS PA
15235-4569
US

V. Phone/Fax

Practice location:
  • Phone: 724-836-4662
  • Fax: 724-836-2876
Mailing address:
  • Phone: 412-345-3517
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD427389
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: