Provider Demographics
NPI:1649314717
Name:DEBRA L STANGO DC
Entity type:Organization
Organization Name:DEBRA L STANGO DC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:STANGO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:412-372-5900
Mailing Address - Street 1:118 FOX RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2762
Mailing Address - Country:US
Mailing Address - Phone:412-372-5900
Mailing Address - Fax:
Practice Address - Street 1:118 FOX RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2762
Practice Address - Country:US
Practice Address - Phone:412-372-5900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1771904OtherBCBS
PA1771904OtherBCBS