MEDICARE: NATALIE RYAN MSW, LSW

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	SW127996	PA

General Provider Information

NPI Number	:	1174915052
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE RYAN MSW, LSW

Provider Business Mailing Address
First Line	:	1104 GROMWELL LN
Second Line	:
City	:	BRIDGEVILLE
State	:	PA
Zip	:	15017-2074
Country	:	US
Telephone Number	:	412-889-3635
Fax Number	:	412-621-6519

Provider Business Practice Location Address
First Line	:	1945 5TH AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15219-5547
Country	:	US
Telephone Number	:	412-246-1649
Fax Number	:	412-621-6519

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

Provider Enumeration Date	:	03/02/2015
Last Update Date	:	03/02/2015

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