Healthcare Provider Details

I. General information

NPI: 1124028774
Provider Name (Legal Business Name): LEENA B. DALAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2005
Last Update Date: 04/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 E NORTH AVE AGH PEDIATRICS
PITTSBURGH PA
15212-4756
US

IV. Provider business mailing address

320 E NORTH AVE AGH PEDIATRICS
PITTSBURGH PA
15212-4756
US

V. Phone/Fax

Practice location:
  • Phone: 412-359-3157
  • Fax: 412-359-3663
Mailing address:
  • Phone: 412-359-3157
  • Fax: 412-359-3663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD035120L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: