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NPI Code Detail

MEDICARE: MATTHEW PLEN OTR/L, DOR

MEDICARE: MATTHEW PLEN OTR/L, DOR
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
1225XP0019XPhysical Rehabilitation Occupational Therapist

General Provider Information

NPI Number : 1497253199
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTHEW PLEN OTR/L, DOR
Provider Business Mailing Address
First Line : 1500 MOUNT VERNON ST APT 3R
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19130-3403
Country : US
Telephone Number : 860-597-3274
Fax Number :
Provider Business Practice Location Address
First Line : 2 FRANKLIN TOWN BLVD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19103-1238
Country : US
Telephone Number : 860-597-3274
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2018
Last Update Date : 01/28/2018

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