MEDICARE: MRS. ERELA M PLOTKIN

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	OC009876	PA

General Provider Information

NPI Number	:	1508999574
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ERELA M PLOTKIN

Provider Business Mailing Address
First Line	:	5663 MELVIN ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15217-2210
Country	:	US
Telephone Number	:	412-779-7950
Fax Number	:	412-422-0211

Provider Business Practice Location Address
First Line	:	5663 MELVIN ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15217-2210
Country	:	US
Telephone Number	:	412-779-7950
Fax Number	:	412-422-0211

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

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	07/08/2007

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