Provider Demographics
NPI:1265527790
Name:LARDO, NANCY P (PHD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:P
Last Name:LARDO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 S BRADDOCK AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15218-1275
Mailing Address - Country:US
Mailing Address - Phone:412-241-8552
Mailing Address - Fax:412-241-8479
Practice Address - Street 1:1201 S BRADDOCK AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15218-1275
Practice Address - Country:US
Practice Address - Phone:412-241-8552
Practice Address - Fax:412-241-8479
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2010-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-007136-L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA348096000OtherMAGELLAN
PAP-62471664OtherMULTI PLAN
PA355727OtherHIGHMARK GROUP NUMBER
PA01573751Medicaid
PA20435OtherUPMC HEALTH PLAN
PA749162Medicare PIN