Basic Information
| Provider Information | |||||||||
| NPI: | 1356429930 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KRIEGER | ||||||||
| FirstName: | EVELINA | ||||||||
| MiddleName: | M. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 320 EAST NORTH AVE | ||||||||
| Address2: | ALLEGHENY GENERAL HOSPITAL DEPT OF PEDIATRICS | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152124756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4123595090 | ||||||||
| FaxNumber: | 4123593663 | ||||||||
| Practice Location | |||||||||
| Address1: | 320 EAST NORTH AVE | ||||||||
| Address2: | ALLEGHENY GENERAL HOSPITAL DEPT OF PEDIATRICS | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152124756 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4123595090 | ||||||||
| FaxNumber: | 4123593663 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2006 | ||||||||
| LastUpdateDate: | 11/02/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MD443956 | PA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 1026439890001 | 05 | PA | MEDICAID |