Provider Demographics
NPI:1003366345
Name:ALLEGHENY MEDICAL P.C.
Entity Type:Organization
Organization Name:ALLEGHENY MEDICAL P.C.
Other - Org Name:ALLEGHENY MEDICAL P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:SHANK
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:412-494-4550
Mailing Address - Street 1:2000 CLIFFMINE RD
Mailing Address - Street 2:PKW 2 SUITE
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15275-1008
Mailing Address - Country:US
Mailing Address - Phone:412-494-4550
Mailing Address - Fax:412-494-6094
Practice Address - Street 1:2000 CLIFFMINE RD
Practice Address - Street 2:PKW 2 SUITE
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15275-1008
Practice Address - Country:US
Practice Address - Phone:412-494-4550
Practice Address - Fax:412-494-6094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Multi-Specialty