MEDICARE: MARYANNE FERCHAK 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	163W00000X	Registered Nurse	RN264733L	PA

General Provider Information

NPI Number	:	1609926401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARYANNE FERCHAK RN

Provider Business Mailing Address
First Line	:	3471 5TH AVE
Second Line	:	SUITE 1110
City	:	PITTSBURGH
State	:	PA
Zip	:	15213-3215
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3471 FIFTH AVE
Second Line	:	SUITE 1110
City	:	PITTSBURGH
State	:	PA
Zip	:	15213-3221
Country	:	US
Telephone Number	:	412-692-2475
Fax Number	:

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

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	06/20/2014

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