1386168623 NPI number — MEGHAN ELIZABETH MACH CRNP

Table of content: MEGHAN ELIZABETH MACH CRNP (NPI 1386168623)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386168623 NPI number — MEGHAN ELIZABETH MACH CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MACH
Provider First Name:
MEGHAN
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SHOLDER
Provider Other First Name:
MEGHAN
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1386168623
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/11/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4815 LIBERTY AVE
Provider Second Line Business Mailing Address:
STE 160
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15224-2156
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-578-6808
Provider Business Mailing Address Fax Number:
412-688-7517

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4800 FRIENDSHIP AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15224-1722
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-578-5000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/28/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  SP017703 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)