Healthcare Provider Details

I. General information

NPI: 1275382509
Provider Name (Legal Business Name): EMILY MARIE ONDO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2024
Last Update Date: 05/17/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1825 MCLAUGHLIN RUN RD
UPPER ST CLAIR PA
15241-2331
US

IV. Provider business mailing address

317 BIRMINGHAM AVE
PITTSBURGH PA
15210-3705
US

V. Phone/Fax

Practice location:
  • Phone: 412-833-1600
  • Fax:
Mailing address:
  • Phone: 412-592-1711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberRTO000564
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: