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NPI Code Detail

MEDICARE: DAVID JOHN CORDISCO PHD

MEDICARE:   DAVID JOHN CORDISCO  PHD
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
1103T00000XPsychologistPS003622LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1160024OTHERORHIGHMARK

General Provider Information

NPI Number : 1972669117
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID JOHN CORDISCO PHD
Provider Business Mailing Address
First Line : 1376 FREEPORT RD
Second Line :
City : PITTSBURGH
State : PA
Zip : 15238-3110
Country : US
Telephone Number : 412-963-7744
Fax Number : 412-486-5059
Provider Business Practice Location Address
First Line : 1376 FREEPORT RD
Second Line :
City : PITTSBURGH
State : PA
Zip : 15238-3110
Country : US
Telephone Number : 412-963-7744
Fax Number : 412-486-5059
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/30/2006
Last Update Date : 07/08/2007

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Directions to “ DAVID JOHN CORDISCO PHD” Practice Location

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