Provider Demographics
NPI:1174861967
Name:FAGELSON, PAMELA SLATT (MPH, NBCR)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:SLATT
Last Name:FAGELSON
Suffix:
Gender:F
Credentials:MPH, NBCR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:SWISSVALE
Mailing Address - State:PA
Mailing Address - Zip Code:15218-1622
Mailing Address - Country:US
Mailing Address - Phone:240-994-7079
Mailing Address - Fax:412-241-7453
Practice Address - Street 1:116 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:SWISSVALE
Practice Address - State:PA
Practice Address - Zip Code:15218-1622
Practice Address - Country:US
Practice Address - Phone:240-994-7079
Practice Address - Fax:412-241-7453
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist