MEDICARE: MARIA PODOLAN

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	225XF0002X	Feeding, Eating & Swallowing Occupational Therapist	007530	OH

General Provider Information

NPI Number	:	1679277909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA PODOLAN

Provider Business Mailing Address
First Line	:	3125 COLERIDGE RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-3528
Country	:	US
Telephone Number	:	724-301-0674
Fax Number	:

Provider Business Practice Location Address
First Line	:	3125 COLERIDGE RD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-3528
Country	:	US
Telephone Number	:	724-301-0674
Fax Number	:

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

Provider Enumeration Date	:	03/29/2023
Last Update Date	:	03/29/2023

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