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MT. LEBANON DERMATOLOGY PC NPI 1114971074


NPI Information

NPI: 1114971074
Provider Name: MT. LEBANON DERMATOLOGY, PC
Classification: Dermatology - 207NS0135X
Entity Type: Organization

Specialization: Procedural Dermatology

CLIA Number: 39D0178905

Address:
607 WASHINGTON RD
LOWER LEVEL
PITTSBURGH, PA
ZIP 15228
Phone: (412) 440-0270
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MT. LEBANON DERMATOLOGY, PC is a procedural dermatology dermatology in Pittsburgh, PA. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). MT. LEBANON DERMATOLOGY, PC NPI is 1114971074. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

607 WASHINGTON RD
LOWER LEVEL
PITTSBURGH, PA
ZIP 15228-903
Phone: (412) 440-0270
Fax: (412) 440-0271

The provider's authorized official is Jacqueline A. Funt .
The authorized official title is Corporate Secretary and has the following contact phone number (412) 440-0270.

The CLIA number assigned to this NPI record is 39D0178905 - skilled nursing/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/22/2006 and was last updated on 4/7/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207NS0135XDermatologyProcedural DermatologyPENNSYLVANIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1B36468MEDICARE UPINPENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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