Healthcare Provider Details

I. General information

NPI: 1538079975
Provider Name (Legal Business Name): ALEXANDER N YATSENKO MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 CRAFT AVE RM A206
PITTSBURGH PA
15213-3005
US

IV. Provider business mailing address

116 OVERLOOK DR
PITTSBURGH PA
15237-2440
US

V. Phone/Fax

Practice location:
  • Phone: 412-641-6290
  • Fax: 412-641-8519
Mailing address:
  • Phone: 713-715-8058
  • Fax: 412-641-8519

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207SM0001X
TaxonomyMolecular Genetic Pathology (Medical Genetics) Physician
License Number2006194
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: