Healthcare Provider Details

I. General information

NPI: 1275454878
Provider Name (Legal Business Name): ENRICO BELLISARIO LPN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3904 GREENSBURG PIKE
PITTSBURGH PA
15221-3908
US

IV. Provider business mailing address

3904 GREENSBURG PIKE
PITTSBURGH PA
15221-3908
US

V. Phone/Fax

Practice location:
  • Phone: 412-285-8407
  • Fax:
Mailing address:
  • Phone: 412-285-8407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberPN252609L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: