Provider Demographics
NPI:1730398678
Name:ABDALLAH, MIRNA (MD)
Entity type:Individual
Prefix:DR
First Name:MIRNA
Middle Name:
Last Name:ABDALLAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 REEDSDALE ST
Mailing Address - Street 2:STE 4004 WESTERN PA ANESTHESIA ASSOCIATES
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15233
Mailing Address - Country:US
Mailing Address - Phone:315-464-4720
Mailing Address - Fax:315-464-4905
Practice Address - Street 1:1501 REEDSDALE ST
Practice Address - Street 2:STE 4004 WESTERN PA ANESTHESIA ASSOCIATES
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15233
Practice Address - Country:US
Practice Address - Phone:412-363-5570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002822207L00000X
PAMD437992207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology