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NPI Code Detail

MEDICARE: DR. MARY EGAN PH. D

MEDICARE: DR. MARY EGAN PH. D
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
1103TC0700XClinical PsychologistPS002123LPA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00195217OTHERPAMEDICARE RR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1006180OTHERPAHIGHMARK
2124692OTHERPAVALUE OPTIONS

General Provider Information

NPI Number : 1356446603
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY EGAN PH. D
Provider Business Mailing Address
First Line : 519 PENN AVE STE 202
Second Line :
City : TURTLE CREEK
State : PA
Zip : 15145-2082
Country : US
Telephone Number : 412-824-8510
Fax Number : 412-824-0948
Provider Business Practice Location Address
First Line : 519 PENN AVE STE 202
Second Line :
City : TURTLE CREEK
State : PA
Zip : 15145-2082
Country : US
Telephone Number : 412-824-8510
Fax Number : 412-824-0948
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2006
Last Update Date : 07/08/2007

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Directions to “ DR. MARY EGAN PH. D” Practice Location

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