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General NPI Number Information
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NPI Number | 1427528413
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Entity Type | Individual
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Provider Name | YEKATERINA YERMOLOVA
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Gender | Female
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Dates
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Enumeration Date | 12/03/2018
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Last Update Date | 12/03/2018
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Provider Practice Location Address
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Address Line | 1200 WELSH RD
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City | NORTH WALES
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State | PA
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Zip | 19454-3771
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Country | US
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Telephone | 215-361-3622
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Fax |
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Provider Business Mailing Address
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Address Line | 301 SILVER OAK CT
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City | WARWICK
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State | PA
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Zip | 18974-3851
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 027383
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License Number State | PA
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