Provider Demographics
NPI:1003222381
Name:SERNA-GALLEGOS, DEREK RAY (MD)
Entity Type:Individual
Prefix:MR
First Name:DEREK
Middle Name:RAY
Last Name:SERNA-GALLEGOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MR
Other - First Name:DEREK
Other - Middle Name:RAY
Other - Last Name:SERNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3600 FORBES AVE
Mailing Address - Street 2:FORBES TOWER - PLAZA LEVE 1 SUITE 140
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5200 CENTRE AVE STE 715
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1327
Practice Address - Country:US
Practice Address - Phone:299-441-2623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-07
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA131445208600000X
PAMD463917208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery