MEDICARE: CODY PAWLOWSKI M.ED., BCBA, LBS

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1336747351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CODY PAWLOWSKI M.ED., BCBA, LBS

Provider Business Mailing Address
First Line	:	429 WASHINGTON AVE STE 3
Second Line	:
City	:	BRIDGEVILLE
State	:	PA
Zip	:	15017-2350
Country	:	US
Telephone Number	:	412-489-6357
Fax Number	:	888-271-0474

Provider Business Practice Location Address
First Line	:	429 WASHINGTON AVE STE 3
Second Line	:
City	:	BRIDGEVILLE
State	:	PA
Zip	:	15017-2350
Country	:	US
Telephone Number	:	412-489-6357
Fax Number	:	888-271-0474

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

Provider Enumeration Date	:	10/12/2020
Last Update Date	:	06/25/2024

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