MEDICARE: MS. LORI DUGAN

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	231H00000X	Audiologist	AT-001119-L	PA

General Provider Information

NPI Number	:	1063633899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LORI DUGAN

Provider Business Mailing Address
First Line	:	901 EATHAN AVE.
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15226
Country	:	US
Telephone Number	:	412-531-8428
Fax Number	:	412-434-0822

Provider Business Practice Location Address
First Line	:	100 5TH AVE
Second Line	:	SUITE 1208
City	:	PITTSBURGH
State	:	PA
Zip	:	15222-1821
Country	:	US
Telephone Number	:	412-471-4352
Fax Number	:	412-434-0822

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

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	07/08/2007

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