MEDICARE: PAUL J FRIDAY 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	PS002382L	PA

General Provider Information

NPI Number	:	1982683165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL J FRIDAY PH.D.

Provider Business Mailing Address
First Line	:	5200 CENTRE AVE
Second Line	:	STE 612
City	:	PITTSBURGH
State	:	PA
Zip	:	15232-1326
Country	:	US
Telephone Number	:	412-683-7396
Fax Number	:	412-682-0502

Provider Business Practice Location Address
First Line	:	5200 CENTRE AVE
Second Line	:	STE 612
City	:	PITTSBURGH
State	:	PA
Zip	:	15232-1326
Country	:	US
Telephone Number	:	412-683-7396
Fax Number	:	412-682-0502

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

Provider Enumeration Date	:	01/16/2006
Last Update Date	:	08/09/2019

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