Provider Demographics
NPI:1861828873
Name:ALLEGHENY CLINIC
Entity Type:Organization
Organization Name:ALLEGHENY CLINIC
Other - Org Name:SPYROS I. MARINIS, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE LIASION
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:NOEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-330-4938
Mailing Address - Street 1:1000 HIGBEE DR
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-4200
Mailing Address - Country:US
Mailing Address - Phone:412-854-7145
Mailing Address - Fax:412-854-7142
Practice Address - Street 1:1000 HIGBEE DR
Practice Address - Street 2:SUITE 107
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-4200
Practice Address - Country:US
Practice Address - Phone:412-854-7145
Practice Address - Fax:412-854-7142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-23
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100731714Medicaid
PA030479Medicare PIN