Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | SP022894 | PA |
NPI | 1124617600 |
---|---|
Provider Name | Mikayla Pollaci |
First Address | Pittsburgh, PA 15224-1334 |
Second Address | Pittsburgh, PA 15224-1334 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2021 |
Last Update Date | 11/01/2021 |