Basic Information
| Provider Information | |||||||||
| NPI: | 1376542134 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALLEGHENY NORTH ARTHRITIS CENTER PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 150 LAKE DR | ||||||||
| Address2: | STE 109 | ||||||||
| City: | WEXFORD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150908405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249350400 | ||||||||
| FaxNumber: | 7249355558 | ||||||||
| Practice Location | |||||||||
| Address1: | 150 LAKE DR | ||||||||
| Address2: | STE 109 | ||||||||
| City: | WEXFORD | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150908405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7249350400 | ||||||||
| FaxNumber: | 7249355558 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2005 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | STUPI | ||||||||
| AuthorizedOfficialFirstName: | ANGELA | ||||||||
| AuthorizedOfficialMiddleName: | MARY | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7249350400 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | PA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
ID Information
| ID | Type | State | Issuer | Description | CM0187 | 01 | PA | RAILROAD MEDICARE | OTHER |