MEDICARE: NATALIA KIPERMAN AUD., CCC-A

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	237600000X	Audiologist-Hearing Aid Fitter	AT006022	PA

General Provider Information

NPI Number	:	1174554661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIA KIPERMAN AUD., CCC-A

Provider Business Mailing Address
First Line	:	2200 BENJAMIN FRANKLIN PKWY
Second Line	:	#E1611
City	:	PHILADELPHIA
State	:	PA
Zip	:	19130-3601
Country	:	US
Telephone Number	:	917-696-9588
Fax Number	:

Provider Business Practice Location Address
First Line	:	1920 CHESTNUT ST
Second Line	:	STE 200
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-4634
Country	:	US
Telephone Number	:	215-561-0106
Fax Number	:

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	01/31/2011

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