MEDICARE: DR. LISA GABRIELLE GAGLIARDI 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	207Q00000X	Family Medicine Physician	MD039973L	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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962402289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA GABRIELLE GAGLIARDI MD

Provider Business Mailing Address
First Line	:	220 ROBINHOOD LN
Second Line	:
City	:	MCMURRAY
State	:	PA
Zip	:	15317-2713
Country	:	US
Telephone Number	:	724-941-8869
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 HOT METAL ST
Second Line	:	ERMI QUANTUM ONE
City	:	PITTSBURGH
State	:	PA
Zip	:	15203-2348
Country	:	US
Telephone Number	:	412-432-7424
Fax Number	:	412-432-7789

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

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	05/13/2008

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