MEDICARE: DR. MARY ELLEN PIKULSKI DO

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	207Q00000X	Family Medicine Physician	OS015519	PA
2	207Q00000X	Family Medicine Physician	0T012377	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	:	1073774220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY ELLEN PIKULSKI DO

Provider Business Mailing Address
First Line	:	PO BOX 536
Second Line	:
City	:	INTERCOURSE
State	:	PA
Zip	:	17534-0536
Country	:	US
Telephone Number	:	610-456-7027
Fax Number	:	610-424-7614

Provider Business Practice Location Address
First Line	:	PO BOX 536
Second Line	:
City	:	INTERCOURSE
State	:	PA
Zip	:	17534-0536
Country	:	US
Telephone Number	:	610-456-7027
Fax Number	:	610-424-7614

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

Provider Enumeration Date	:	06/20/2008
Last Update Date	:	02/12/2026

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