Healthcare Provider Details

I. General information

NPI: 1063760676
Provider Name (Legal Business Name): RANJITA PALLAVI M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2012
Last Update Date: 12/04/2020
Certification Date: 12/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 ROBINSON PLZ STE 430
PITTSBURGH PA
15205-1018
US

IV. Provider business mailing address

247 MOREWOOD AVE
PITTSBURGH PA
15213-1861
US

V. Phone/Fax

Practice location:
  • Phone: 412-325-5500
  • Fax: 412-489-8050
Mailing address:
  • Phone: 412-622-0290
  • Fax: 412-681-7605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number27415
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number27415
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: