MEDICARE: MRS. HELENA MARIA PINGREE MPT

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	PT011137L	PA

General Provider Information

NPI Number	:	1821121385
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HELENA MARIA PINGREE MPT

Provider Business Mailing Address
First Line	:	312 FAYETTE DR
Second Line	:
City	:	CRANBERRY TOWNSHIP
State	:	PA
Zip	:	16066-7314
Country	:	US
Telephone Number	:	724-776-8019
Fax Number	:

Provider Business Practice Location Address
First Line	:	3 SAINT FRANCIS WAY
Second Line	:	PASSAVANT CRANBERRY MEDICAL CTR. SUITE 205
City	:	CRANBERRY TOWNSHIP
State	:	PA
Zip	:	16066-5122
Country	:	US
Telephone Number	:	724-772-5340
Fax Number	:	724-772-5807

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

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	07/08/2007

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