MEDICARE: JAMIE KAZOS MSW

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	104100000X	Social Worker	SW013540	PA

General Provider Information

NPI Number	:	1114107695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE KAZOS MSW

Provider Business Mailing Address
First Line	:	111 SAINT CHARLES CT
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15238-2718
Country	:	US
Telephone Number	:	412-736-6725
Fax Number	:	412-828-2772

Provider Business Practice Location Address
First Line	:	111 SAINT CHARLES CT
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15238-2718
Country	:	US
Telephone Number	:	412-736-6725
Fax Number	:	412-828-2772

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

Provider Enumeration Date	:	11/13/2007
Last Update Date	:	11/13/2007

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