Healthcare Provider Details

I. General information

NPI: 1659475390
Provider Name (Legal Business Name): JAMES & CHAROLETTE ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 SOUTHERN AVE
PITTSBURGH PA
15211-1910
US

IV. Provider business mailing address

160 SOUTHERN AVE
PITTSBURGH PA
15211-1910
US

V. Phone/Fax

Practice location:
  • Phone: 412-431-0711
  • Fax: 412-431-0732
Mailing address:
  • Phone: 412-431-0711
  • Fax: 412-431-0732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: HEATHER KELLY
Title or Position: PRACTICE MANAGER
Credential:
Phone: 412-431-0711