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2400 Ardmore Blvd Suite 301 Pittsburgh PA 15221-5299 | |
| (412) 351-6090 | |
| (412) 351-6960 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 2400 Ardmore Blvd, Pittsburgh, Pennsylvania |
| Authorized Official Name and Position | Cecili R Jones (ANALYST) |
| Authorized Official Contact | 4123304813 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2400 Ardmore Blvd Suite 301 Pittsburgh PA 15221-5299 Ph: (412) 351-6090 | 2400 Ardmore Blvd Suite 301 Pittsburgh PA 15221-5299 Ph: (412) 351-6090 |
| NPI Number | 1801222948 |
|---|---|
| Provider Enumeration Date | 09/20/2013 |
| Last Update Date | 04/08/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801222948 | NPI | - | NPPES |
| 100731714 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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