MEDICARE: DR. BETSY W. BLAZEK-O'NEILL MD

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	208100000X	Physical Medicine & Rehabilitation Physician	MD044471L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	10923243	OTHER		CAQH

General Provider Information

NPI Number	:	1710987979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BETSY W. BLAZEK-O'NEILL MD

Provider Business Mailing Address
First Line	:	100 S JACKSON AVE
Second Line	:	3RD FLOOR
City	:	PITTSBURGH
State	:	PA
Zip	:	15202-3428
Country	:	US
Telephone Number	:	412-359-8951
Fax Number	:	412-734-7795

Provider Business Practice Location Address
First Line	:	100 S JACKSON AVE
Second Line	:	3RD FLOOR
City	:	PITTSBURGH
State	:	PA
Zip	:	15202-3428
Country	:	US
Telephone Number	:	412-359-8951
Fax Number	:	412-734-7795

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

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	12/01/2020

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Directions to “ DR. BETSY W. BLAZEK-O'NEILL MD” Practice Location

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