Healthcare Provider Details

I. General information

NPI: 1861860942
Provider Name (Legal Business Name): ERIN MCDONOUGH-MAYO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2015
Last Update Date: 09/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 BROAD ST SUITE 421
SEWICKLEY PA
15143-1681
US

IV. Provider business mailing address

104 BEECHWOOD DR
INDUSTRY PA
15052-1740
US

V. Phone/Fax

Practice location:
  • Phone: 412-741-2552
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP015313
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: