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General NPI Number Information
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NPI Number | 1619012820
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Entity Type | Organization
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Legal Business Name | PITTSBURGH NEUROLOGY CONSULTANTS
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 07/09/2010
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Provider Practice Location Address
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Address Line | 2571 MOSSIDE BLVD SUITE 4
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City | MONROEVILLE
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State | PA
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Zip | 15146-3510
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Country | US
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Telephone | 412-856-4171
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Fax | 412-856-8273
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Provider Business Mailing Address
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Address Line | 2571 MOSSIDE BLVD SUITE 4
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City | MONROEVILLE
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State | PA
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Zip | 15146-3510
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Country | US
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Telephone | 412-856-4171
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Fax | 412-856-8273
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Authorized Official
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Title or Position | SECRETARY
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Name | MRS. BETSY A. GUMP
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Credential |
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Telephone | 412-856-4171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 022678-E
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License Number State | PA
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