MEDICARE: DR. DAVID PRYBOCK PH.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	103TC0700X	Clinical Psychologist	PS015862	PA

General Provider Information

NPI Number	:	1730352337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID PRYBOCK PH.D.

Provider Business Mailing Address
First Line	:	134 S HIGHLAND AVE
Second Line	:	SUITE 17
City	:	PITTSBURGH
State	:	PA
Zip	:	15206-3968
Country	:	US
Telephone Number	:	412-952-5348
Fax Number	:

Provider Business Practice Location Address
First Line	:	134 S HIGHLAND AVE
Second Line	:	SUITE 17
City	:	PITTSBURGH
State	:	PA
Zip	:	15206-3968
Country	:	US
Telephone Number	:	412-952-5348
Fax Number	:

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

Provider Enumeration Date	:	04/04/2008
Last Update Date	:	12/08/2013

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