Provider Demographics
NPI:1255644480
Name:PANICCIA, ALESSANDRO
Entity type:Individual
Prefix:
First Name:ALESSANDRO
Middle Name:
Last Name:PANICCIA
Suffix:
Gender:M
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 425 SCAIFE HALL
Mailing Address - Street 2:3RD FLOOR PRESBY
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15261-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3550 TERRACE STREET
Practice Address - Street 2:3RD FLOOR PRESBY
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15261-2527
Practice Address - Country:US
Practice Address - Phone:412-235-1307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4601022086X0206X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program