MEDICARE: EMILY EGAN

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	225XP0200X	Pediatric Occupational Therapist	0119005940	VA
2	225X00000X	Occupational Therapist	OC016270	PA

General Provider Information

NPI Number	:	1689939753
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY EGAN

Provider Business Mailing Address
First Line	:	1005 BEAVER GRADE RD STE 120
Second Line	:
City	:	MOON TOWNSHIP
State	:	PA
Zip	:	15108-2964
Country	:	US
Telephone Number	:	412-742-0964
Fax Number	:

Provider Business Practice Location Address
First Line	:	1005 BEAVER GRADE RD STE 120
Second Line	:
City	:	MOON TOWNSHIP
State	:	PA
Zip	:	15108-2964
Country	:	US
Telephone Number	:	412-742-0964
Fax Number	:

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

Provider Enumeration Date	:	07/05/2012
Last Update Date	:	03/06/2026

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Directions to “ EMILY EGAN ” Practice Location

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