Provider Demographics
NPI:1700888534
Name:ALLEGHENY CLINIC
Entity type:Organization
Organization Name:ALLEGHENY CLINIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGED CARE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-330-5220
Mailing Address - Street 1:2000 OXFORD DR
Mailing Address - Street 2:SUITE 113
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1827
Mailing Address - Country:US
Mailing Address - Phone:412-831-1929
Mailing Address - Fax:412-831-2285
Practice Address - Street 1:2000 OXFORD DR
Practice Address - Street 2:SUITE 113
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-1827
Practice Address - Country:US
Practice Address - Phone:412-831-1929
Practice Address - Fax:412-831-2285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007317140321Medicaid
PA1007317140321Medicaid
PA030717Medicare PIN