Healthcare Provider Details

I. General information

NPI: 1427695535
Provider Name (Legal Business Name): CHARLENE GUARNACCIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2019
Last Update Date: 12/08/2019
Certification Date: 12/08/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 ANDERSEN DR STE 400
PITTSBURGH PA
15220-2733
US

IV. Provider business mailing address

468 MYOMA RD
MARS PA
16046-2322
US

V. Phone/Fax

Practice location:
  • Phone: 412-227-3800
  • Fax:
Mailing address:
  • Phone: 724-831-0501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: