MEDICARE: GERRIAN M BOBROWSKY PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	3580-L	PA

General Provider Information

NPI Number	:	1174550529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERRIAN M BOBROWSKY PHD

Provider Business Mailing Address
First Line	:	615 WASHINGTON RD
Second Line	:	SUITE #515
City	:	PITTSBURGH
State	:	PA
Zip	:	15228-1901
Country	:	US
Telephone Number	:	412-561-2121
Fax Number	:

Provider Business Practice Location Address
First Line	:	615 WASHINGTON RD
Second Line	:	SUITE #515
City	:	PITTSBURGH
State	:	PA
Zip	:	15228-1901
Country	:	US
Telephone Number	:	412-561-2121
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	07/21/2022

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