Healthcare Provider Details

I. General information

NPI: 1609966837
Provider Name (Legal Business Name): AMANDA LOVALLO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 08/18/2021
Certification Date: 07/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 PENN AVE AOB 2ND FLOOR
PITTSBURGH PA
15224-5815
US

IV. Provider business mailing address

4401 PENN AVE AOB 2ND FLOOR
PITTSBURGH PA
15224-5815
US

V. Phone/Fax

Practice location:
  • Phone: 412-692-7692
  • Fax:
Mailing address:
  • Phone: 412-692-7692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD429911
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberMD429911
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: