Healthcare Provider Details

I. General information

NPI: 1558895011
Provider Name (Legal Business Name): RUCHA P JIYANI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2017
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 BLAZIER DR
WEXFORD PA
15090-9508
US

IV. Provider business mailing address

500 BLAZIER DR
WEXFORD PA
15090-9508
US

V. Phone/Fax

Practice location:
  • Phone: 412-359-8900
  • Fax: 412-359-8977
Mailing address:
  • Phone: 412-359-8900
  • Fax: 412-359-8977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD490096
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: