MEDICARE: DR. SUSAN PILOSSOPH M.D.

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	146M00000X	Intermediate Emergency Medical Technician	MD-055075-L	PA

General Provider Information

NPI Number	:	1669637351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN PILOSSOPH M.D.

Provider Business Mailing Address
First Line	:	3515 WASHINGTON RD
Second Line	:	SUITE 550
City	:	MC MURRAY
State	:	PA
Zip	:	15317-3063
Country	:	US
Telephone Number	:	724-969-4321
Fax Number	:	724-941-6948

Provider Business Practice Location Address
First Line	:	3515 WASHINGTON RD
Second Line	:	SUITE 550
City	:	MC MURRAY
State	:	PA
Zip	:	15317-3063
Country	:	US
Telephone Number	:	724-969-4321
Fax Number	:	724-941-6948

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

Provider Enumeration Date	:	07/23/2008
Last Update Date	:	01/13/2010

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