MEDICARE: BETHANY BLOCK

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	163W00000X	Registered Nurse	RN618997	PA
2	363L00000X	Nurse Practitioner	SP019589	PA

General Provider Information

NPI Number	:	1295545341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETHANY BLOCK

Provider Business Mailing Address
First Line	:	811 RED BARN CT
Second Line	:
City	:	BETHEL PARK
State	:	PA
Zip	:	15102-3257
Country	:	US
Telephone Number	:	412-736-4539
Fax Number	:

Provider Business Practice Location Address
First Line	:	2551 WASHINGTON RD STE 811
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15241-2513
Country	:	US
Telephone Number	:	412-238-2800
Fax Number	:

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

Provider Enumeration Date	:	01/10/2025
Last Update Date	:	03/07/2025

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Directions to “ BETHANY BLOCK ” Practice Location

Language	Start Address	Practice Location

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