MEDICARE: EMILY NICOLE MONGELLUZZO PA-C

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	363AS0400X	Surgical Physician Assistant	MA066628	PA
2	363AS0400X	Surgical Physician Assistant	OA007730	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	16560093	OTHER		CAQH

General Provider Information

NPI Number	:	1477447464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY NICOLE MONGELLUZZO PA-C

Provider Business Mailing Address
First Line	:	4815 LIBERTY AVE STE 425
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15224-2156
Country	:	US
Telephone Number	:	412-359-4352
Fax Number	:

Provider Business Practice Location Address
First Line	:	4815 LIBERTY AVE STE 425
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15224-2156
Country	:	US
Telephone Number	:	412-359-4352
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2025
Last Update Date	:	06/10/2026

Similar Medicare Providers

1659952877 — MAXWELL FRANCIS PEDRE DO
Practice Location Address:

4815 LIBERTY AVE STE 439
PITTSBURGH, PA
15224-2156

Practice Phone: 724-260-7300
Practice Fax:

1366213464 — MS. EMILY KATHRYN CRUSAN
Practice Location Address:

4815 LIBERTY AVE STE 215
PITTSBURGH, PA
15224-2156

Practice Phone: 412-235-5900
Practice Fax: 412-235-5901

1629902960 — CAITLIN WAHAL MS
Practice Location Address:

4815 LIBERTY AVE
PITTSBURGH, PA
15224-2156

Practice Phone: 412-578-3951
Practice Fax:

1457883332 — DR. JORDAN LEIGH GLADYS-ORYHON DO
Practice Location Address:

4815 LIBERTY AVE STE M56
PITTSBURGH, PA
15224-2156

Practice Phone: 412-359-8900
Practice Fax: 412-359-8977

1982600425 — JAMES ROSSETTI
Practice Location Address:

4815 LIBERTY AVE , STE GR70
PITTSBURGH, PA
15224-2156

Practice Phone: 412-578-4484
Practice Fax:

1669477196 — RICHARD KINGSLEY SHADDUCK MD
Practice Location Address:

4815 LIBERTY AVE , STE GR70
PITTSBURGH, PA
15224-2156

Practice Phone: 412-578-4484
Practice Fax: 412-578-3536

Directions to “ EMILY NICOLE MONGELLUZZO PA-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.