Healthcare Provider Details

I. General information

NPI: 1316079627
Provider Name (Legal Business Name): KATHLEEN ANN ALLEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 07/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 GREENTREE RD BUILDING 4 PARKWAY CENTER
PITTSBURGH PA
15220-3508
US

IV. Provider business mailing address

118 GROVE HILL RD
BADEN PA
15005-9626
US

V. Phone/Fax

Practice location:
  • Phone: 412-920-7675
  • Fax: 412-920-7977
Mailing address:
  • Phone: 412-920-7675
  • Fax: 412-920-7977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0104X
TaxonomyChemical Pathology Physician
License NumberMD072583L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207ZP0105X
TaxonomyClinical Pathology/Laboratory Medicine Physician
License Number062131
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number062131
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: