Healthcare Provider Details

I. General information

NPI: 1669336293
Provider Name (Legal Business Name): AMANDA ALAKSIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11279 PERRY HWY STE 505
WEXFORD PA
15090-9396
US

IV. Provider business mailing address

11279 PERRY HWY STE 505
WEXFORD PA
15090-9396
US

V. Phone/Fax

Practice location:
  • Phone: 412-206-1158
  • Fax: 412-219-5205
Mailing address:
  • Phone: 412-206-1158
  • Fax: 412-219-5205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN630773
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: