Provider Demographics
NPI:1053312546
Name:O'TOOLE, EILEEN MALONEY (CRNP)
Entity Type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:MALONEY
Last Name:O'TOOLE
Suffix:
Gender:F
Credentials:CRNP
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Mailing Address - Street 1:320 E NORTH AVE
Mailing Address - Street 2:AGH COLON & RECTAL SURGERY
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-4756
Mailing Address - Country:US
Mailing Address - Phone:412-359-3901
Mailing Address - Fax:412-359-4514
Practice Address - Street 1:320 E NORTH AVE
Practice Address - Street 2:AGH COLON & RECTAL SURGERY
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-4756
Practice Address - Country:US
Practice Address - Phone:412-359-3901
Practice Address - Fax:412-359-4514
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAVP003852B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS84839Medicare UPIN