MEDICARE: TARA BELLISARIO

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	231H00000X	Audiologist	AT005838	PA

General Provider Information

NPI Number	:	1730109869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TARA BELLISARIO

Provider Business Mailing Address
First Line	:	217 ROCK RUN RD
Second Line	:
City	:	MCMURRAY
State	:	PA
Zip	:	15317-6622
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 E SWISSVALE AVE
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15218-1443
Country	:	US
Telephone Number	:	412-244-4208
Fax Number	:

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

Provider Enumeration Date	:	07/20/2006
Last Update Date	:	07/08/2007

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Directions to “ TARA BELLISARIO ” Practice Location

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