Basic Information
| Provider Information | |||||||||
| NPI: | 1518059435 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MATHEO | ||||||||
| FirstName: | LORETA | ||||||||
| MiddleName: | MYRA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 LOTHROP STREET | ||||||||
| Address2: | FORBES TOWER SUITE 9055 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126471042 | ||||||||
| FaxNumber: | 4126474486 | ||||||||
| Practice Location | |||||||||
| Address1: | 3420 5TH AVENUE | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126926677 | ||||||||
| FaxNumber: | 4126928584 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 2080A0000X | MD046568L | PA | Y | Allopathic & Osteopathic Physicians | Pediatrics | Adolescent Medicine |
No ID Information.