Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | MT216285 | PA |
NPI | 1124507009 |
---|---|
Provider Name | Mrs. Deirdre Elizabeth Vailas |
First Address | Pittsburgh, PA 15213-3410 |
Second Address | Pittsburgh, PA 15213-3215 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2018 |
Last Update Date | 10/08/2018 |