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General NPI Number Information
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NPI Number | 1932277126
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Entity Type | Organization
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Legal Business Name | PHYLLIS MONTELLESE LLC
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Dates
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Enumeration Date | 12/04/2006
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Last Update Date | 11/28/2007
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Provider Practice Location Address
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Address Line | 128 N CRAIG ST SUITE 216
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City | PITTSBURGH
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State | PA
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Zip | 15213-2744
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Country | US
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Telephone | 412-681-3200
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Fax |
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Provider Business Mailing Address
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Address Line | 128 NORTH CRAIG STREET SUITE 216
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City | PITTSBURGH
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State | PA
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Zip | 15213-4824
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Country | US
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Telephone | 412-681-3200
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | PHYLLIS MONTELLESE
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Credential | M.D.
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Telephone | 412-681-3200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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