MEDICARE: MR. GUY SANCHIOLI MS, ATC, PES

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	2255A2300X	Athletic Trainer	RT-000830-A	PA

General Provider Information

NPI Number	:	1386634194
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GUY SANCHIOLI MS, ATC, PES

Provider Business Mailing Address
First Line	:	2466 POTOMAC AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15216-2752
Country	:	US
Telephone Number	:	412-480-3541
Fax Number	:	412-432-3774

Provider Business Practice Location Address
First Line	:	1000 KELTON AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15216-2421
Country	:	US
Telephone Number	:	412-571-6022
Fax Number	:	412-571-6057

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

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	07/08/2007

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