MEDICARE: BERNADETTE C CONNOR PHD

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	103T00000X	Psychologist	PS001308L	PA

General Provider Information

NPI Number	:	1083670608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BERNADETTE C CONNOR PHD

Provider Business Mailing Address
First Line	:	4284 WILLIAM FLYNN HWY
Second Line	:	STE 211
City	:	ALLISON PARK
State	:	PA
Zip	:	15101-1440
Country	:	US
Telephone Number	:	412-486-2400
Fax Number	:	412-486-2411

Provider Business Practice Location Address
First Line	:	4284 WILLIAM FLYNN HWY
Second Line	:	STE 211
City	:	ALLISON PARK
State	:	PA
Zip	:	15101-1440
Country	:	US
Telephone Number	:	412-486-2400
Fax Number	:	412-486-2411

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

Provider Enumeration Date	:	04/22/2006
Last Update Date	:	02/24/2016

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