Healthcare Provider Details

I. General information

NPI: 1235196585
Provider Name (Legal Business Name): FAMILY PROFESSIONAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 10/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 CURRY HOLLOW ROAD FAMILY PROFESSIONAL CENTER
PITTSBURGH PA
15236
US

IV. Provider business mailing address

330 CURRY HOLLOW ROAD FAMILY PROFESSIONAL CENTER
PITTSBURGH PA
15236
US

V. Phone/Fax

Practice location:
  • Phone: 412-653-4900
  • Fax: 412-653-9969
Mailing address:
  • Phone: 412-653-4900
  • Fax: 412-653-9969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH PHILIP RUDOLPH
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 412-653-4900