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General NPI Number Information
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NPI Number | 1336576834
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Entity Type | Organization
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Legal Business Name | GOLLA CENTER FOR PLASTIC SURGERY
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Dates
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Enumeration Date | 09/30/2013
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Last Update Date | 10/31/2013
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Provider Practice Location Address
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Address Line | 107 GAMMA DR SUITE 210
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City | PITTSBURGH
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State | PA
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Zip | 15238-2917
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Country | US
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Telephone | 412-596-7081
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Fax |
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Provider Business Mailing Address
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Address Line | 1027 BANK ST
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City | BRIDGEVILLE
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State | PA
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Zip | 15017-2201
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Country | US
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Telephone | 412-977-1966
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. DINAKAR GOLLA
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Credential | M.D.
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Telephone | 412-596-7081
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | SP013109
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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