Healthcare Provider Details

I. General information

NPI: 1346281276
Provider Name (Legal Business Name): CLINICAL & INTERVENTIONAL CARDIOLOGY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 DELAFIELD RD SUITE 303
PITTSBURGH PA
15215-3247
US

IV. Provider business mailing address

100 DELAFIELD RD SUITE 303
PITTSBURGH PA
15215-3247
US

V. Phone/Fax

Practice location:
  • Phone: 412-784-5400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number038252E
License Number StatePA

VIII. Authorized Official

Name: TRACI ANNE TEDESCO
Title or Position: OFFICE ADMINISTRATOR
Credential:
Phone: 412-784-5400