MEDICARE: JULANNE BIBRO-RUCH LCSW

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	1041C0700X	Clinical Social Worker	CW015835	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CW015835	OTHER	PA	SOCIAL WORK

General Provider Information

NPI Number	:	1487679395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULANNE BIBRO-RUCH LCSW

Provider Business Mailing Address
First Line	:	377 BROADWAY DR
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15236-4138
Country	:	US
Telephone Number	:	412-551-1000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1720 WASHINGTON RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15241-1208
Country	:	US
Telephone Number	:	412-854-4887
Fax Number	:

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	08/27/2012

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