MEDICARE: REBECCA A. GERMANO AU.D.

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	231H00000X	Audiologist	AT-000529-L	PA
2	231H00000X	Audiologist	41YA00030000	NJ

General Provider Information

NPI Number	:	1811990351
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA A. GERMANO AU.D.

Provider Business Mailing Address
First Line	:	1920 CHESTNUT ST
Second Line	:	SUITE 200
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-4634
Country	:	US
Telephone Number	:	215-561-0550
Fax Number	:

Provider Business Practice Location Address
First Line	:	1920 CHESTNUT ST
Second Line	:	SUITE 200
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-4634
Country	:	US
Telephone Number	:	215-561-0550
Fax Number	:

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

Provider Enumeration Date	:	05/30/2005
Last Update Date	:	09/07/2007

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