Provider Demographics
NPI:1225073380
Name:WEST PENN ALLEGHENY HEALTH SYSTEM, INC.
Entity Type:Organization
Organization Name:WEST PENN ALLEGHENY HEALTH SYSTEM, INC.
Other - Org Name:THE FOOT AND ANKLE INSTITUTE OF WESTERN PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, PRACTICE MANAGEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDICINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-858-7691
Mailing Address - Street 1:2570 HAYMAKER RD OFC BLDG1
Mailing Address - Street 2:SUITE 211
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3513
Mailing Address - Country:US
Mailing Address - Phone:412-858-7698
Mailing Address - Fax:412-858-4372
Practice Address - Street 1:2566 HAYMAKER RD
Practice Address - Street 2:SUITE 211
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3517
Practice Address - Country:US
Practice Address - Phone:412-858-7699
Practice Address - Fax:412-858-7696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007277200089Medicaid
PA5757580001Medicare NSC
PA1007277200089Medicaid