Basic Information
Provider Information
NPI: 1063806115
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PRONESTI
FirstName: ELIZABETH
MiddleName: JOSEPHINE
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1000 BOWER HILL ROAD
Address2: ATTN ST CLAIR HOSPITAL - AFFILIATE BILLING - PAMALYN
City: PITTSBURGH
State: PA
PostalCode: 152431873
CountryCode: US
TelephoneNumber: 4129422548
FaxNumber:  
Practice Location
Address1: 1050 BOWER HILL RD STE 205
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152431868
CountryCode: US
TelephoneNumber: 4127881330
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/26/2015
LastUpdateDate: 02/26/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/26/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000XMT208635PAY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

No ID Information.


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