Healthcare Provider Details

I. General information

NPI: 1881891406
Provider Name (Legal Business Name): CHRISTOPHER PASSERO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2007
Last Update Date: 04/06/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 LYTTON AVE STE 300 SUITE 501
PITTSBURGH PA
15213-1481
US

IV. Provider business mailing address

200 LOTHROP ST SUITE 501
PITTSBURGH PA
15213-2536
US

V. Phone/Fax

Practice location:
  • Phone: 412-802-3043
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberMD431441
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: