Healthcare Provider Details

I. General information

NPI: 1306158746
Provider Name (Legal Business Name): SOBIA MANSOOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2010
Last Update Date: 07/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 PENN AVE DEPARTMENT OF ANESTHESIA - SUITE 5643
PITTSBURGH PA
15224-1334
US

IV. Provider business mailing address

4401 PENN AVE DEPARTMENT OF ANESTHESIA - SUITE 5643
PITTSBURGH PA
15224-1334
US

V. Phone/Fax

Practice location:
  • Phone: 412-692-7341
  • Fax:
Mailing address:
  • Phone: 412-692-7341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD438628
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License NumberMD438628
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207LP3000X
TaxonomyPediatric Anesthesiology Physician
License Number27763
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: