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General NPI Number Information
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NPI Number | 1619936077
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Entity Type | Individual
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Provider Name | FREDERICK L PORKOLAB MD
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Gender | Male
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Dates
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Enumeration Date | 03/22/2006
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Last Update Date | 01/05/2011
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Provider Practice Location Address
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Address Line | 4727 FRIENDSHIP AVE STE 180
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City | PITTSBURGH
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State | PA
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Zip | 15224-1779
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Country | US
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Telephone | 412-235-5881
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Fax | 412-235-5878
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Provider Business Mailing Address
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Address Line | 2781 LEECHBURG RD
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City | LOWER BURRELL
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State | PA
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Zip | 15068
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Country | US
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Telephone | 724-226-3345
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Fax | 724-226-2415
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD016838E
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number | MD016838E
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License Number State | PA
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