=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174120828
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MEGAN FAITH KAUFMAN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/06/2020
-----------------------------------------------------
Last Update Date | 11/15/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5115 CENTRE AVE FL 4
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15232-1301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 124-864-6600
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 211 11TH ST
-----------------------------------------------------
City | SHARPSBURG
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15215-2310
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-303-5581
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363AM0700X
-----------------------------------------------------
Taxonomy Name | Medical Physician Assistant
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------