Healthcare Provider Details

I. General information

NPI: 1578072450
Provider Name (Legal Business Name): MRS. JOANN MARY SEIGEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 CARMELL DRIVE
PITTSBURGH PA
15241
US

IV. Provider business mailing address

410 CARMELL DR
PITTSBURGH PA
15241-1773
US

V. Phone/Fax

Practice location:
  • Phone: 412-720-4987
  • Fax: 724-223-7712
Mailing address:
  • Phone: 412-720-4987
  • Fax: 724-223-7712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License NumberRP031880L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: