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NPI Code Detail

MEDICARE: DR. ELIZABETH BOGADO BRIGANTI PSYD

MEDICARE: DR. ELIZABETH BOGADO BRIGANTI PSYD
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 PsychologistPS016488PA

General Provider Information

NPI Number : 1538307392
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ELIZABETH BOGADO BRIGANTI PSYD
Provider Business Mailing Address
First Line : 28 GARRETT AVE
Second Line :
City : BRYN MAWR
State : PA
Zip : 19010-1400
Country : US
Telephone Number : 267-475-3744
Fax Number :
Provider Business Practice Location Address
First Line : 28 GARRETT AVE
Second Line :
City : BRYN MAWR
State : PA
Zip : 19010-1400
Country : US
Telephone Number : 267-475-3744
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2009
Last Update Date : 01/30/2009

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