MEDICARE: ELLYN WINSKI MT-BC

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	225A00000X	Music Therapist	16796	IL

General Provider Information

NPI Number	:	1689427817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLYN WINSKI MT-BC

Provider Business Mailing Address
First Line	:	108 LEVERING ST APT S3
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19127-1442
Country	:	US
Telephone Number	:	219-242-2040
Fax Number	:

Provider Business Practice Location Address
First Line	:	4910 WYNNEFIELD AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19131-2616
Country	:	US
Telephone Number	:	215-320-2640
Fax Number	:

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

Provider Enumeration Date	:	04/08/2024
Last Update Date	:	04/08/2024

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