Healthcare Provider Details
I. General information
NPI: 1265530257
Provider Name (Legal Business Name): WESTERN PENNSYLVANIA OB/GYN MULTISPECIALTY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4815 LIBERTY AVE SUITE 330
PITTSBURGH PA
15224-2156
US
IV. Provider business mailing address
4815 LIBERTY AVE SUITE 321
PITTSBURGH PA
15224-2156
US
V. Phone/Fax
- Phone: 412-578-5588
- Fax: 412-605-6544
- Phone: 412-578-5504
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
GREGORIO
DELGADO
Title or Position: CHIEF OF STAFF
Credential: MD
Phone: 412-578-5504