MEDICARE: DR. ELIZABETH LEE FOGARTY 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	PS002228L	PA
2	103T00000X	Psychologist	PS002228L	PA

General Provider Information

NPI Number	:	1053317586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH LEE FOGARTY PH.D.

Provider Business Mailing Address
First Line	:	307 4TH AVE
Second Line	:	STE 300
City	:	PITTSBURGH
State	:	PA
Zip	:	15222-2120
Country	:	US
Telephone Number	:	412-391-1816
Fax Number	:	412-391-6640

Provider Business Practice Location Address
First Line	:	307 4TH AVE
Second Line	:	STE 300
City	:	PITTSBURGH
State	:	PA
Zip	:	15222-2120
Country	:	US
Telephone Number	:	412-391-1816
Fax Number	:	412-391-6640

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

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	09/11/2025

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