MEDICARE: MRS. ELLEN KAPLAN FEINGLASS PT

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	225100000X	Physical Therapist	15400	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	F6400001	OTHER	MD	BLUECHOICE

General Provider Information

NPI Number	:	1356404537
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELLEN KAPLAN FEINGLASS PT

Provider Business Mailing Address
First Line	:	11 EAST MOUNT ROYAL AVENUE
Second Line	:	SUITE 104
City	:	BALTIMORE
State	:	MD
Zip	:	21202-5504
Country	:	US
Telephone Number	:	410-576-2484
Fax Number	:	410-576-0434

Provider Business Practice Location Address
First Line	:	11 EAST MOUNT ROYAL AVENUE
Second Line	:	SUITE 104
City	:	BALTIMORE
State	:	MD
Zip	:	21202-5504
Country	:	US
Telephone Number	:	410-576-2484
Fax Number	:	410-576-0434

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

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	07/08/2007

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