Healthcare Provider Details

I. General information

NPI: 1033402243
Provider Name (Legal Business Name): ALEJANDRO JOSE LOPEZ-MAGALLON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4401 PENN AVE FL 4
PITTSBURGH PA
15224-1334
US

IV. Provider business mailing address

4401 PENN AVE FL 4
PITTSBURGH PA
15224-1334
US

V. Phone/Fax

Practice location:
  • Phone: 412-692-7366
  • Fax:
Mailing address:
  • Phone: 412-692-7366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberLT000709
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberMD445889
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: