Provider Demographics
NPI:1235445081
Name:TAKAHASHI, MITSUKO (DO)
Entity Type:Individual
Prefix:DR
First Name:MITSUKO
Middle Name:
Last Name:TAKAHASHI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 COAL VALLEY RD
Mailing Address - Street 2:SUITE 504
Mailing Address - City:JEFFERSON HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3730
Mailing Address - Country:US
Mailing Address - Phone:412-469-7900
Mailing Address - Fax:412-469-7919
Practice Address - Street 1:575 COAL VALLEY RD
Practice Address - Street 2:SUITE 504
Practice Address - City:JEFFERSON HILLS
Practice Address - State:PA
Practice Address - Zip Code:15025-3730
Practice Address - Country:US
Practice Address - Phone:412-469-7900
Practice Address - Fax:412-469-7919
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-30
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY255743208G00000X
PAOS016181208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)