Justin Richard Davanzo
Neurosurgeon
2580 Haymaker Rd Ste 106
Monroeville
, Pennsylvania 15146-3500
Justin Richard Davanzo
Neurosurgeon
2580 Haymaker Rd Ste 106
Monroeville
, Pennsylvania 15146-3500
(412) 858-7769
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About
Features
Specialties
- Neurosurgeon
Languages spoken
- English
Location
First Address
- Justin Richard Davanzo
- 2580 Haymaker Rd Ste 106
- Monroeville, PA
- Zip : 15146-3500
- Fax : (412) 858-7769
- Phone : (412) 858-7766
Second Address
- Justin Richard Davanzo
- 2580 Haymaker Rd Ste 106
- Monroeville, PA
- Zip : 15146-3500
- Fax : (412) 858-7769
- Phone : (412) 858-7766
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207T00000X | Neurosurgeon | MD457862 | PA |
National Provider Identifier
| NPI | 1114269545 |
|---|---|
| Provider Name | Justin Richard Davanzo |
| First Address | Monroeville, PA 15146-3500 |
| Second Address | Monroeville, PA 15146-3500 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 24/03/2013 |
| Last Update Date | 01/10/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 14653990 | CAQH (01) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.