MEDICARE: DR. JOANA FELICIANO DPT

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	PT020077	PA

General Provider Information

NPI Number	:	1366775975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOANA FELICIANO DPT

Provider Business Mailing Address
First Line	:	4111 HOYT ST
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16510-3561
Country	:	US
Telephone Number	:	814-860-1162
Fax Number	:

Provider Business Practice Location Address
First Line	:	13609 CALIFORNIA ST
Second Line	:	SUITE 200
City	:	OMAHA
State	:	NE
Zip	:	68154-5260
Country	:	US
Telephone Number	:	800-456-5857
Fax Number	:	402-895-7812

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

Provider Enumeration Date	:	09/14/2009
Last Update Date	:	09/14/2009

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