MEDICARE: MRS. PATRICIA ANN TRAUBERT-BAUM

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	183500000X	Pharmacist	RP033964L	PA

General Provider Information

NPI Number	:	1760795892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PATRICIA ANN TRAUBERT-BAUM

Provider Business Mailing Address
First Line	:	2470 CITATION CT
Second Line	:
City	:	WEXFORD
State	:	PA
Zip	:	15090-7959
Country	:	US
Telephone Number	:	724-935-5509
Fax Number	:

Provider Business Practice Location Address
First Line	:	1710 MOUNT ROYAL BLVD
Second Line	:
City	:	GLENSHAW
State	:	PA
Zip	:	15116-2115
Country	:	US
Telephone Number	:	412-487-8767
Fax Number	:

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

Provider Enumeration Date	:	07/18/2010
Last Update Date	:	07/18/2010

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