Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | MA054899 | PA |
NPI | 1013201409 |
---|---|
Provider Name | Leiren Pantages |
First Address | Pittsburgh, PA 15213-3108 |
Second Address | Pittsburgh, PA 15213-3108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2011 |
Last Update Date | 25/03/2021 |