MEDICARE: BECKIE ANN KOBI MSOTR/L

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	225X00000X	Occupational Therapist	OC003197L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	50031766	OTHER	PA	CAPITAL BLUE CROSS
2	372927	OTHER	PA	BLUE SHIELD GROUP #
3	MA1345150	OTHER	PA	BLUE SHIELD IND. PROVID #
4	814196	OTHER	PA	FIRST PRIORITY HEALTH

General Provider Information

NPI Number	:	1437167921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BECKIE ANN KOBI MSOTR/L

Provider Business Mailing Address
First Line	:	1998 BAKER RD
Second Line	:
City	:	PITTSTON TWP
State	:	PA
Zip	:	18640-9511
Country	:	US
Telephone Number	:	570-237-0939
Fax Number	:	570-824-6621

Provider Business Practice Location Address
First Line	:	1998 BAKER RD
Second Line	:
City	:	PITTSTON TWP
State	:	PA
Zip	:	18640-9511
Country	:	US
Telephone Number	:	570-237-0939
Fax Number	:	570-824-6621

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

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	04/05/2022

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Directions to “ BECKIE ANN KOBI MSOTR/L” Practice Location

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