Healthcare Provider Details
I. General information
NPI: 1225589781
Provider Name (Legal Business Name): LAUREN GESHAY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/20/2016
Last Update Date: 10/09/2020
Certification Date: 10/09/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
490 E NORTH AVE SUITE 300
PITTSBURGH PA
15212-4771
US
IV. Provider business mailing address
490 E NORTH AVE SUITE 300
PITTSBURGH PA
15212-4771
US
V. Phone/Fax
- Phone: 412-322-7202
- Fax: 412-322-2144
- Phone: 412-322-7202
- Fax: 412-322-2144
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | MA058630 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: