Basic Information
| Provider Information | |||||||||
| NPI: | 1548234396 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCINTIRE | ||||||||
| FirstName: | SARA | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4401 PENN AVENUE | ||||||||
| Address2: | FACULTY OFFICE PAVILION, 3RD FLOOR, PEDIATRIC HOSPITAL | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152242524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126925135 | ||||||||
| FaxNumber: | 4126927038 | ||||||||
| Practice Location | |||||||||
| Address1: | 4401 PENN AVENUE | ||||||||
| Address2: | FACULTY OFFICE PAVILION, 3RD FLOOR, PEDIATRIC HOSPITAL | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152242524 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126925135 | ||||||||
| FaxNumber: | 4126927038 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2006 | ||||||||
| LastUpdateDate: | 09/14/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | MD041778L | PA | N | Other Service Providers | Specialist | 208000000X | MD041778 | PA | N | Allopathic & Osteopathic Physicians | Pediatrics | 208000000X | MD041778L | PA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 001945534 | 05 | PA | MEDICAID |