Healthcare Provider Details

I. General information

NPI: 1306013115
Provider Name (Legal Business Name): JOANNA SUET FONG-ISARIYAWONGSE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2008
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

532 S AIKEN AVE SUITE 300
PITTSBURGH PA
15232-1521
US

IV. Provider business mailing address

532 S AIKEN AVE SUITE 300
PITTSBURGH PA
15232-1521
US

V. Phone/Fax

Practice location:
  • Phone: 412-681-2000
  • Fax:
Mailing address:
  • Phone: 412-681-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084E0001X
TaxonomyEpilepsy Physician
License NumberMD448987
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD448987
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: