Healthcare Provider Details

I. General information

NPI: 1174185847
Provider Name (Legal Business Name): SUZANNE GAROFALO PHDHP, RDH, MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2019
Last Update Date: 07/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1527 WINDCREST DR
PITTSBURGH PA
15206-1366
US

IV. Provider business mailing address

1527 WINDCREST DR
PITTSBURGH PA
15206-1366
US

V. Phone/Fax

Practice location:
  • Phone: 412-377-4627
  • Fax: 412-361-2651
Mailing address:
  • Phone: 412-377-4627
  • Fax: 412-361-2651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH007120L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberPHDH001099
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: