Healthcare Provider Details

I. General information

NPI: 1386806149
Provider Name (Legal Business Name): BETH BENNETT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2008
Last Update Date: 08/02/2025
Certification Date: 08/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HALKET ST
PITTSBURGH PA
15213-3108
US

IV. Provider business mailing address

300 HALKET ST
PITTSBURGH PA
15213-3108
US

V. Phone/Fax

Practice location:
  • Phone: 412-641-8181
  • Fax: 412-641-5313
Mailing address:
  • Phone: 412-641-8181
  • Fax: 412-641-5313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD442027
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: