Healthcare Provider Details

I. General information

NPI: 1700601069
Provider Name (Legal Business Name): CIERRA CAUTELA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2024
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4727 FRIENDSHIP AVE
PITTSBURGH PA
15224-1779
US

IV. Provider business mailing address

4727 FRIENDSHIP AVE
PITTSBURGH PA
15224-1779
US

V. Phone/Fax

Practice location:
  • Phone: 412-904-3216
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: