Healthcare Provider Details

I. General information

NPI: 1912261280
Provider Name (Legal Business Name): MALLORY STRICKLAND CIUKSZA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2012
Last Update Date: 03/09/2021
Certification Date: 03/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 MOUNT LEBANON BLVD STE 306
PITTSBURGH PA
15234-1252
US

IV. Provider business mailing address

1000 BOWER HILL RD ATTN ST CLAIR HOSPITAL - AFFILIATE BILLING - PAMALYN
PITTSBURGH PA
15243-1873
US

V. Phone/Fax

Practice location:
  • Phone: 412-563-5560
  • Fax: 412-563-6697
Mailing address:
  • Phone: 412-942-2548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD455523
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: