Provider Demographics
NPI:1073653796
Name:FRAGELLO, TALIA MARIE (MPAS, PA-C)
Entity Type:Individual
Prefix:MRS
First Name:TALIA
Middle Name:MARIE
Last Name:FRAGELLO
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Gender:F
Credentials:MPAS, PA-C
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Mailing Address - Street 1:1000 BOWER HILL ROAD
Mailing Address - Street 2:ATTN ST CLAIR HOSPITAL - AFFILIATE BILLING - PAMALYN
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15243-1873
Mailing Address - Country:US
Mailing Address - Phone:412-942-2548
Mailing Address - Fax:
Practice Address - Street 1:2000 OXFORD DR STE 302
Practice Address - Street 2:
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-1841
Practice Address - Country:US
Practice Address - Phone:412-942-7295
Practice Address - Fax:412-942-7287
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2021-03-09
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Provider Licenses
StateLicense IDTaxonomies
PAMA051992363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant