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General NPI Number Information
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NPI Number | 1538331152
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Entity Type | Organization
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Legal Business Name | ALLEGHENY CLINIC
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Dates
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Enumeration Date | 03/25/2008
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Last Update Date | 05/12/2017
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Provider Practice Location Address
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Address Line | 490 E NORTH AVE STE 500
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City | PITTSBURGH
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State | PA
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Zip | 15212-4765
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Country | US
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Telephone | 412-359-8860
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Fax | 412-359-8809
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Provider Business Mailing Address
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Address Line | 490 E NORTH AVE STE 500
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City | PITTSBURGH
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State | PA
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Zip | 15212-4765
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Country | US
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Telephone | 412-359-8860
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Fax | 412-359-8809
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Authorized Official
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Title or Position | PROVIDER CREDENTIALING SPECIALIST
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Name | CANDICE GENTILE
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Credential |
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Telephone | 412-330-5853
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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