Healthcare Provider Details

I. General information

NPI: 1144656158
Provider Name (Legal Business Name): ALLEGHENY CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2013
Last Update Date: 04/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5140 LIBERTY AVE
PITTSBURGH PA
15224-2215
US

IV. Provider business mailing address

5140 LIBERTY AVE
PITTSBURGH PA
15224-2215
US

V. Phone/Fax

Practice location:
  • Phone: 412-682-2100
  • Fax: 412-682-4303
Mailing address:
  • Phone: 412-682-2100
  • Fax: 412-682-4303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number StatePA

VIII. Authorized Official

Name: DENISE NOEL
Title or Position: PRACTICE LIASION
Credential:
Phone: 412-330-4938