Provider Demographics
NPI:1336188820
Name:LAGNESE, JOHN M (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:LAGNESE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:600 WATERCREST WAY
Mailing Address - Street 2:SUITE 630
Mailing Address - City:CHESWICK
Mailing Address - State:PA
Mailing Address - Zip Code:15024-1370
Mailing Address - Country:US
Mailing Address - Phone:724-274-9451
Mailing Address - Fax:724-274-9370
Practice Address - Street 1:103 GAMMA DR
Practice Address - Street 2:SUITE 120
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-2976
Practice Address - Country:US
Practice Address - Phone:412-781-1917
Practice Address - Fax:412-781-1536
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2011-08-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD022852E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010117420001Medicaid
PA0010117420001Medicaid
PA112113Medicare ID - Type Unspecified