Provider Demographics
NPI:1447312772
Name:LATTANZI, DANIEL R (MD)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:R
Last Name:LATTANZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 LOTHROP ST
Mailing Address - Street 2:SUITE 9055 FORBES TOWER
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-2536
Mailing Address - Country:US
Mailing Address - Phone:412-647-3087
Mailing Address - Fax:
Practice Address - Street 1:1000 BOWER HILL RD
Practice Address - Street 2:SUITE 311
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15243-1873
Practice Address - Country:US
Practice Address - Phone:412-942-3590
Practice Address - Fax:412-942-3598
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD024231E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0013041360007Medicaid
B34857Medicare UPIN
B34857Medicare UPIN