MEDICARE: ANGELICA PILSON

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	347D00000X	Train

General Provider Information

NPI Number	:	1215707401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELICA PILSON

Provider Business Mailing Address
First Line	:	326 ARGYLE AVE
Second Line	:
City	:	BOARDMAN
State	:	OH
Zip	:	44512-2320
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	326 ARGYLE AVE
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44512-2320
Country	:	US
Telephone Number	:	234-313-3649
Fax Number	:

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

Provider Enumeration Date	:	01/08/2024
Last Update Date	:	01/08/2024

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Directions to “ ANGELICA PILSON ” Practice Location

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