Provider Demographics
NPI:1699049353
Name:ALLEGHENY MEDICAL & WELLNESS ASSOCIATES, LLC
Entity type:Organization
Organization Name:ALLEGHENY MEDICAL & WELLNESS ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:F
Authorized Official - Last Name:HAKAS
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:724-224-2224
Mailing Address - Street 1:825 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:BRACKENRIDGE
Mailing Address - State:PA
Mailing Address - Zip Code:15014-1085
Mailing Address - Country:US
Mailing Address - Phone:724-224-2224
Mailing Address - Fax:724-226-3988
Practice Address - Street 1:825 10TH AVE
Practice Address - Street 2:
Practice Address - City:BRACKENRIDGE
Practice Address - State:PA
Practice Address - Zip Code:15014-1085
Practice Address - Country:US
Practice Address - Phone:724-224-2224
Practice Address - Fax:724-226-3988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-28
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD026161L174400000X
PASP010604174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty