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NPI Code Detail

MEDICARE: MICHELE GABRIELE MOT

MEDICARE: MICHELE GABRIELE MOT
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
1225X00000XOccupational TherapistPENDINGPA

General Provider Information

NPI Number : 1457642233
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELE GABRIELE MOT
Provider Business Mailing Address
First Line : 2 W 10TH ST
Second Line :
City : MARCUS HOOK
State : PA
Zip : 19061-4513
Country : US
Telephone Number : 610-859-8850
Fax Number : 610-859-7876
Provider Business Practice Location Address
First Line : 8019 FRANKFORD AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19136-2786
Country : US
Telephone Number : 215-338-8900
Fax Number : 215-338-8923
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/27/2011
Last Update Date : 04/27/2011

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