Provider Demographics
NPI:1558509257
Name:TALLUTO, MARIANNE C (PA-C)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:C
Last Name:TALLUTO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 LYTTON AVE STE 100A
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-1481
Mailing Address - Country:US
Mailing Address - Phone:412-647-4545
Mailing Address - Fax:412-647-4505
Practice Address - Street 1:120 LYTTON AVE STE 100A
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-1481
Practice Address - Country:US
Practice Address - Phone:412-647-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-03
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA051593363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant