Healthcare Provider Details

I. General information

NPI: 1942850144
Provider Name (Legal Business Name): REBECCA ZANECOSKY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2019
Last Update Date: 10/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 PENN AVENUE PLAZA BUILIDING 4TH FLOOR
PITTSBURGH PA
15224
US

IV. Provider business mailing address

709 MICA DR
ALLISON PARK PA
15101-4231
US

V. Phone/Fax

Practice location:
  • Phone: 412-692-6393
  • Fax:
Mailing address:
  • Phone: 610-955-8774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License NumberRN648356
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberSP020918
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: