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NPI Code Detail

MEDICARE: DAVID LACKNER

MEDICARE: DAVID LACKNER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianMD036163EPA

General Provider Information

NPI Number : 1023005154
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID LACKNER
Provider Business Mailing Address
First Line : 400 PENN CENTER BLVD
Second Line : STE 555
City : PITTSBURGH
State : PA
Zip : 15235-5613
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 25 HECKEL RD
Second Line : DEPARTMENT OF RADIOLOGY
City : MC KEES ROCKS
State : PA
Zip : 15136-1651
Country : US
Telephone Number : 412-777-6258
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2005
Last Update Date : 06/15/2021

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Directions to “ DAVID LACKNER ” Practice Location

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