MEDICARE: JESSICA RUBINO

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	225X00000X	Occupational Therapist	OC102104	PA

General Provider Information

NPI Number	:	1770872624
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA RUBINO

Provider Business Mailing Address
First Line	:	3390 SAXONBURG BLVD.
Second Line	:	SUITE 250
City	:	GLENSHAW
State	:	PA
Zip	:	15116-3160
Country	:	US
Telephone Number	:	412-767-5967
Fax Number	:	412-767-5960

Provider Business Practice Location Address
First Line	:	3390 SAXONBURG BLVD.
Second Line	:	SUITE 250
City	:	GLENSHAW
State	:	PA
Zip	:	15116-3160
Country	:	US
Telephone Number	:	412-767-5967
Fax Number	:	412-767-5960

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

Provider Enumeration Date	:	03/31/2011
Last Update Date	:	03/31/2011

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