Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0300X | Periodontist | DF11032 | MA |
Y | 1223P0300X | Periodontist | RFD000031 | PA |
NPI | 1053704619 |
---|---|
Provider Name | Giuseppe Intini |
First Address | Pittsburgh, PA 15261-0001 |
Second Address | Pittsburgh, PA 15261-5819 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2015 |
Last Update Date | 19/04/2021 |