Mt. Lebanon Dermatology, PC

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

Legal business name

MT. LEBANON DERMATOLOGY, PC

Practice address

607 Washington Rd
Lower Level
Pittsburgh, PA 15228-1903

Phone

(412) 440-0270

Fax

(412) 440-0271

NPI assigned

May 22, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Jacqueline A. Funt

Title

Corporate Secretary

Phone

(412) 440-0270

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428364800000",
    "number": "1114971074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 WASHINGTON RD",
            "address_2": "LOWER LEVEL",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152281903",
            "telephone_number": "412-440-0270",
            "fax_number": "412-440-0271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 WASHINGTON RD",
            "address_2": "LOWER LEVEL",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152281903",
            "telephone_number": "412-440-0270",
            "fax_number": "412-440-0271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT. LEBANON DERMATOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2015-04-07",
        "status": "A",
        "authorized_official_last_name": "FUNT",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CORPORATE SECRETARY",
        "authorized_official_telephone_number": "412-440-0270",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Procedural Dermatology Physician in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Procedural Dermatology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.