Basic Information
| Provider Information | |||||||||
| NPI: | 1386832343 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DANDACHI | ||||||||
| FirstName: | NADINE | ||||||||
| MiddleName: | GHOSSOUB | ||||||||
| NamePrefix: | |||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | EL EZZEDDIN | ||||||||
| OtherFirstName: | NADINE | ||||||||
| OtherMiddleName: | GHOSSOUB | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 200 LOTHROP ST | ||||||||
| Address2: | FORBES TOWER, ROOM 9055 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152132536 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126473087 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3601 5TH AVE | ||||||||
| Address2: | 4TH FLOOR FALK, COMPREHENSIVE LUNG CENTER | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152133403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126486161 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2007 | ||||||||
| LastUpdateDate: | 06/05/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD444779 | PA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.