Provider Demographics
NPI:1003274754
Name:MACEDONIA, LORI SMITH
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:SMITH
Last Name:MACEDONIA
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LORI
Other - Middle Name:S
Other - Last Name:MACEDONIA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:3459 5TH AVE
Mailing Address - Street 2:4 WEST MONTEFIORE HOSPITAL, ALZHEIMER RESEARCH CENTER
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3236
Mailing Address - Country:US
Mailing Address - Phone:412-692-2700
Mailing Address - Fax:412-692-2710
Practice Address - Street 1:3459 5TH AVE
Practice Address - Street 2:4 WEST MONTEFIORE HOSPITAL, ALZHEIMER RESEARCH CENTER
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3236
Practice Address - Country:US
Practice Address - Phone:412-692-2700
Practice Address - Fax:412-692-2710
Is Sole Proprietor?:No
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA000348L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical