Provider Demographics
NPI:1841871787
Name:CERMIGNANO, SAMANTHA LYN (MD)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:LYN
Last Name:CERMIGNANO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SAMANTHA
Other - Middle Name:LYN
Other - Last Name:INNIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3600 FORBES AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3410
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4401 PENN AVENUE
Practice Address - Street 2:FACULTY PAVILION SUITE 1200
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224
Practice Address - Country:US
Practice Address - Phone:412-692-7812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT233907207SG0201X
TXV2705208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
No208000000XAllopathic & Osteopathic PhysiciansPediatrics