Colleen McDonnell Dattilo, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD024017E Issued in PA

Practice address

625 Ridgeview Dr
Pittsburgh, PA 15228-1705

Phone

(412) 343-7629

NPI assigned

Aug 28, 2009

Last updated

Aug 28, 2009By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Colleen McDonnell Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1251417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251417600000",
    "number": "1255564910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 RIDGEVIEW DR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152281705",
            "telephone_number": "412-343-7629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 RIDGEVIEW DR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152281705",
            "telephone_number": "412-343-7629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATTILO",
        "first_name": "COLLEEN",
        "middle_name": "MCDONNELL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-28",
        "last_updated": "2009-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD024017E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "COLLEEN",
            "last_name": "MCDONNELL",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anil Dasyam
• Navya Dasyam
• Graceanne Elizabeth Dates, PA-C
• Alexie Nina Marie Florentino Datta, PT
• Dattilo and Hall LLC
• David J Dattilo, DDS
• Lawrence Paul Dattilo, D.M.D.
• James H Dauber, MD
• Janessa Marie Dauber
• Daugherty Wellness LLC

• Pediatrics Physician in Pittsburgh, PA
• Providers in Pittsburgh, PA by specialty
• Pediatrics Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2009; 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.