Provider Demographics
NPI:1487959839
Name:LYSOSOMAL STORAGE DISEASE CLINICAL CARE NETWORK LLC
Entity type:Organization
Organization Name:LYSOSOMAL STORAGE DISEASE CLINICAL CARE NETWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRANGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-734-4672
Mailing Address - Street 1:21 WILSON DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15202-1321
Mailing Address - Country:US
Mailing Address - Phone:412-734-4672
Mailing Address - Fax:412-734-5476
Practice Address - Street 1:21 WILSON DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15202-1321
Practice Address - Country:US
Practice Address - Phone:412-734-4672
Practice Address - Fax:412-734-5476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-17
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)Group - Single Specialty