MEDICARE: MARTIN ELSASS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	171WH0202X	Home Modifications Contractor
2	171WV0202X	Vehicle Modifications Contractor
3	172A00000X	Driver
4	1744G0900X	Graphics Designer
5	374U00000X	Home Health Aide
6	376J00000X	Homemaker
7	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1194433680
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARTIN ELSASS

Provider Business Mailing Address
First Line	:	1708 COLUMBIANA LISBON RD
Second Line	:
City	:	COLUMBIANA
State	:	OH
Zip	:	44408-9441
Country	:	US
Telephone Number	:	330-272-8574
Fax Number	:

Provider Business Practice Location Address
First Line	:	1708 COLUMBIANA LISBON RD
Second Line	:
City	:	COLUMBIANA
State	:	OH
Zip	:	44408-9441
Country	:	US
Telephone Number	:	330-272-8574
Fax Number	:

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

Provider Enumeration Date	:	11/14/2022
Last Update Date	:	11/14/2022

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Directions to “ MARTIN ELSASS ” Practice Location

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