Provider Demographics
NPI:1902877392
Name:PIETRAGALLO, LOUIS D (MD)
Entity type:Individual
Prefix:
First Name:LOUIS
Middle Name:D
Last Name:PIETRAGALLO
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 DRAKE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-1505
Mailing Address - Country:US
Mailing Address - Phone:412-831-1320
Mailing Address - Fax:412-831-9748
Practice Address - Street 1:101 DRAKE RD
Practice Address - Street 2:SUITE B
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-1505
Practice Address - Country:US
Practice Address - Phone:412-831-1320
Practice Address - Fax:412-831-9748
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD014765E207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB40773Medicare UPIN
PA179932Medicare ID - Type Unspecified