MEDICARE: HARRIETS INNERWEAR

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	225000000X	Orthotic Fitter

General Provider Information

NPI Number	:	1124216924
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARRIETS INNERWEAR

Provider Business Mailing Address
First Line	:	1725 E PASSYUNK AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19148-1517
Country	:	US
Telephone Number	:	215-468-5100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1725 E PASSYUNK AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19148-1517
Country	:	US
Telephone Number	:	215-468-5100
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BARBARA SHAPIRO
Credential	:
Telephone Number	:	215-468-5100

Provider Enumeration Date	:	10/06/2007
Last Update Date	:	11/09/2007

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Directions to “HARRIETS INNERWEAR ” Practice Location

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