Provider Demographics
NPI:1396390506
Name:RANALLI, VINCE (MASTER DPP TRAINER)
Entity Type:Individual
Prefix:
First Name:VINCE
Middle Name:
Last Name:RANALLI
Suffix:
Gender:M
Credentials:MASTER DPP TRAINER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 BAUM BLVD STE 306
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-3793
Mailing Address - Country:US
Mailing Address - Phone:412-593-2048
Mailing Address - Fax:844-311-7396
Practice Address - Street 1:5750 BAUM BLVD # 306
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-3793
Practice Address - Country:US
Practice Address - Phone:412-593-2048
Practice Address - Fax:844-311-7396
Is Sole Proprietor?:No
Enumeration Date:2019-08-05
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
888703OtherIN PERSON CDC DPP CERT
PA1038862390002Medicaid