Basic Information
| Provider Information | |||||||||
| NPI: | 1134794068 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PITIGALA | ||||||||
| FirstName: | RAYHAN | ||||||||
| MiddleName: | PRASANTHA | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3600 FORBES AVE | ||||||||
| Address2: | FORBES TOWER SUITE 140 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152133410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126476340 | ||||||||
| FaxNumber: | 4126475809 | ||||||||
| Practice Location | |||||||||
| Address1: | 1515 LOCUST ST STE 1 | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152195131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4122328411 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/24/2021 | ||||||||
| LastUpdateDate: | 11/15/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 390200000X | MT224128 | PA | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.