Healthcare Provider Details

I. General information

NPI: 1386674356
Provider Name (Legal Business Name): WEST PENN ALLEGHENY HEALTH SYSTEM, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 07/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4815 LIBERTY AVE SUITE 338
PITTSBURGH PA
15224-2156
US

IV. Provider business mailing address

4815 LIBERTY AVE SUITE 338
PITTSBURGH PA
15224-2156
US

V. Phone/Fax

Practice location:
  • Phone: 412-578-0282
  • Fax:
Mailing address:
  • Phone: 412-578-0282
  • Fax: 412-578-0259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number
License Number StatePA
# 5
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StatePA

VIII. Authorized Official

Name: CECILI JONES
Title or Position: ENROLLMENT SPECIALIST
Credential:
Phone: 412-330-4813