Healthcare Provider Details

I. General information

NPI: 1891312492
Provider Name (Legal Business Name): MARIA WUNDERLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2020
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 S WATER ST SUITE 200
PITTSBURGH PA
15203-2307
US

IV. Provider business mailing address

3200 S WATER ST SUITE 200
PITTSBURGH PA
15203-2307
US

V. Phone/Fax

Practice location:
  • Phone: 412-432-3651
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP022030
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: