Healthcare Provider Details

I. General information

NPI: 1699401802
Provider Name (Legal Business Name): ALLEGHENY CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2022
Last Update Date: 07/29/2022
Certification Date: 07/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 QUINN DR STE 140
PITTSBURGH PA
15275-1055
US

IV. Provider business mailing address

200 QUINN DR STE 140
PITTSBURGH PA
15275-1055
US

V. Phone/Fax

Practice location:
  • Phone: 412-980-1620
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RICHARD FRIES
Title or Position: VP FINANCE
Credential:
Phone: 412-330-2472