Healthcare Provider Details

I. General information

NPI: 1366951220
Provider Name (Legal Business Name): JOSEPH LAWLOR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2017
Last Update Date: 09/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5230 CENTRE AVE
PITTSBURGH PA
15232-1304
US

IV. Provider business mailing address

2209 WOODMONT DR
EXPORT PA
15632-8954
US

V. Phone/Fax

Practice location:
  • Phone: 412-632-1040
  • Fax:
Mailing address:
  • Phone: 412-965-1913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRN657913
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: