Healthcare Provider Details

I. General information

NPI: 1558051110
Provider Name (Legal Business Name): STEPHANIE VULCANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2023
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 GAMMA DR STE 210
PITTSBURGH PA
15238-2936
US

IV. Provider business mailing address

67 GREEN ST
HOUSTON PA
15342-1169
US

V. Phone/Fax

Practice location:
  • Phone: 412-963-6677
  • Fax:
Mailing address:
  • Phone: 571-422-8071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP027522
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: