MEDICARE: MRS. WAI MUN AU

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	225700000X	Massage Therapist	207881	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831344241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. WAI MUN AU

Provider Business Mailing Address
First Line	:	1231 CHESTNUT ST.
Second Line	:	#128
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107
Country	:	US
Telephone Number	:	267-255-4039
Fax Number	:

Provider Business Practice Location Address
First Line	:	1231 CHESTNUT ST.
Second Line	:	#128
City	:	PHILADELPHIA
State	:	PA
Zip	:	19107
Country	:	US
Telephone Number	:	267-255-4039
Fax Number	:

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

Provider Enumeration Date	:	11/26/2008
Last Update Date	:	11/26/2008

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