MEDICARE: ANDREW ALLEN TEMOSHENKA MPT

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	225100000X	Physical Therapist	PT008316-L	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
2	753508	OTHER	PA	KEYSTONE HEALTHPLAN WEST

General Provider Information

NPI Number	:	1275502965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW ALLEN TEMOSHENKA MPT

Provider Business Mailing Address
First Line	:	1295 GRAND BLVD
Second Line	:	STE. 102
City	:	MONESSEN
State	:	PA
Zip	:	15062-1955
Country	:	US
Telephone Number	:	724-684-6000
Fax Number	:	724-684-6010

Provider Business Practice Location Address
First Line	:	1295 GRAND BLVD
Second Line	:	STE. 102
City	:	MONESSEN
State	:	PA
Zip	:	15062-1955
Country	:	US
Telephone Number	:	724-684-6000
Fax Number	:	724-684-6010

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

Provider Enumeration Date	:	03/15/2006
Last Update Date	:	07/08/2007

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