Healthcare Provider Details

I. General information

NPI: 1700055514
Provider Name (Legal Business Name): WEST PENN PHYSICIAN PRACTICE NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2008
Last Update Date: 07/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 TOWNE SQUARE WAY BRENTWOOD TOWNE SQUARE
PITTSBURGH PA
15227-3254
US

IV. Provider business mailing address

147 TOWNE SQUARE WAY BRENTWOOD TOWNE SQUARE
PITTSBURGH PA
15227-3254
US

V. Phone/Fax

Practice location:
  • Phone: 412-942-1085
  • Fax: 412-865-3035
Mailing address:
  • Phone: 412-942-1085
  • Fax: 412-865-3035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHELE G LEY
Title or Position: MANAGED CARE SPECIALIST
Credential:
Phone: 412-330-5207