Basic Information
| Provider Information | |||||||||
| NPI: | 1598757346 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALLEGHENY IMAGING OF MCCANDLESS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 49 | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152300049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4129375949 | ||||||||
| FaxNumber: | 4129375705 | ||||||||
| Practice Location | |||||||||
| Address1: | 9335 MCKNIGHT RD | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152375903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4123598743 | ||||||||
| FaxNumber: | 4123598233 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2005 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | KIPROFF | ||||||||
| AuthorizedOfficialFirstName: | PAUL | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 4123594113 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.