MEDICARE: MRS. DESSA Y MRVOS RN

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	261QH0100X	Health Service Clinic/Center	RN262485L	PA

General Provider Information

NPI Number	:	1598190167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DESSA Y MRVOS RN

Provider Business Mailing Address
First Line	:	600 FORBES AVE
Second Line	:	UNION 2ND FLOOR
City	:	PITTSBURGH
State	:	PA
Zip	:	15219-3016
Country	:	US
Telephone Number	:	412-396-1650
Fax Number	:	412-396-5655

Provider Business Practice Location Address
First Line	:	600 FORBES AVE
Second Line	:	UNION 2ND FLOOR
City	:	PITTSBURGH
State	:	PA
Zip	:	15219-3016
Country	:	US
Telephone Number	:	412-396-1650
Fax Number	:	412-396-5655

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

Provider Enumeration Date	:	09/13/2013
Last Update Date	:	09/13/2013

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