Healthcare Provider Details

I. General information

NPI: 1063996841
Provider Name (Legal Business Name): EMILY LANCASTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2018
Last Update Date: 09/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 PENN AVE
PITTSBURGH PA
15224-1334
US

IV. Provider business mailing address

4552 PENN AVE APT 1
PITTSBURGH PA
15224-1314
US

V. Phone/Fax

Practice location:
  • Phone: 126-927-8104
  • Fax: 412-692-7596
Mailing address:
  • Phone: 231-838-9556
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License NumberGC000461
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: