Provider Demographics
NPI:1184928699
Name:RADKAY-GONZALEZ, LISA
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:RADKAY-GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3550 TERRACE STREET
Mailing Address - Street 2:A711 SCAIFE HALL
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15261
Mailing Address - Country:US
Mailing Address - Phone:412-802-6013
Mailing Address - Fax:
Practice Address - Street 1:3550 TERRACE STREET
Practice Address - Street 2:A711 SCAIFE HALL
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15261
Practice Address - Country:US
Practice Address - Phone:412-802-6013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-28
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program