MEDICARE: ALLEGHENY CLINIC

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
1	207Q00000X	Family Medicine Physician	MD443975	PA

General Provider Information

NPI Number	:	1467811190
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLEGHENY CLINIC

Provider Business Mailing Address
First Line	:	4 ALLEGHENY CTR FL 7
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15212-5255
Country	:	US
Telephone Number	:	412-330-5861
Fax Number	:	412-330-5844

Provider Business Practice Location Address
First Line	:	5889 FORBES AVE
Second Line	:	SUITE 200
City	:	PITTSBURGH
State	:	PA
Zip	:	15217-4601
Country	:	US
Telephone Number	:	412-618-3010
Fax Number	:	412-618-3011

Authorized Official
Title or Position	:	DIRECTOR PROVIDER ENROLLMENT
Name	:	DENISE NOEL
Credential	:
Telephone Number	:	412-330-5861

Provider Enumeration Date	:	02/23/2016
Last Update Date	:	11/06/2020

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Directions to “ALLEGHENY CLINIC ” Practice Location

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