Healthcare Provider Details

I. General information

NPI: 1760577530
Provider Name (Legal Business Name): MAUREEN ANN DUKE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 06/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 FORT COUCH RD SUITE 375
PITTSBURGH PA
15241-1041
US

IV. Provider business mailing address

180 FORT COUCH RD SUITE 375
PITTSBURGH PA
15241-1041
US

V. Phone/Fax

Practice location:
  • Phone: 412-833-8811
  • Fax: 412-833-7011
Mailing address:
  • Phone: 412-833-8811
  • Fax: 412-833-7011

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberOA002131
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA052674
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: