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NPI Code Detail

MEDICARE: MICHELLE FLORENCE BAUN OT

MEDICARE: MICHELLE FLORENCE BAUN OT
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 TherapistOC005699LPA

General Provider Information

NPI Number : 1659496974
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE FLORENCE BAUN OT
Provider Business Mailing Address
First Line : 25 CHURCH RD
Second Line :
City : ELKINS PARK
State : PA
Zip : 19027-2205
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8015 LAWNDALE AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19111-1507
Country : US
Telephone Number : 215-725-2525
Fax Number : 215-745-3970
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2007
Last Update Date : 07/08/2007

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