Provider Demographics
NPI:1598731895
Name:TOLEDO, FREDERICO GRANCHI (MD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICO
Middle Name:GRANCHI
Last Name:TOLEDO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:FREDERICO
Other - Middle Name:GRANCHI STEIDEL
Other - Last Name:DE TOLEDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3601 5TH AVE
Mailing Address - Street 2:FALK CLINIC, SUITE 2B
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3403
Mailing Address - Country:US
Mailing Address - Phone:412-383-8700
Mailing Address - Fax:
Practice Address - Street 1:3601 5TH AVE
Practice Address - Street 2:FALK CLINIC, SUITE 2B
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3403
Practice Address - Country:US
Practice Address - Phone:412-383-8700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD424244174400000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101032594Medicaid
PA101032594Medicaid
PA078575Medicare ID - Type Unspecified