Provider Demographics
NPI:1053316000
Name:HALENDA, GREGORY (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:
Last Name:HALENDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2790 MOSSIDE BLVD
Mailing Address - Street 2:STE G110
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2766
Mailing Address - Country:US
Mailing Address - Phone:412-372-6330
Mailing Address - Fax:412-372-3319
Practice Address - Street 1:2580 HAYMAKER RD
Practice Address - Street 2:STE 401
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3500
Practice Address - Country:US
Practice Address - Phone:412-372-6330
Practice Address - Fax:412-372-3319
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD033880E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA251219366OtherFEDERAL TAX ID#
PA480423EE0Medicare PIN