MEDICARE: ANNA ELLENBERGER DPT

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	225100000X	Physical Therapist	38902	CA
2	225100000X	Physical Therapist	PT026891	PA

General Provider Information

NPI Number	:	1700147626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA ELLENBERGER DPT

Provider Business Mailing Address
First Line	:	324 RODI RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15235-3318
Country	:	US
Telephone Number	:	412-242-7880
Fax Number	:	412-242-6040

Provider Business Practice Location Address
First Line	:	4262 OLD WILLIAM PENN HWY
Second Line	:	PROFESSIONAL COMMONS
City	:	PITTSBURGH
State	:	PA
Zip	:	15668-1953
Country	:	US
Telephone Number	:	724-387-1000
Fax Number	:	724-387-1011

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

Provider Enumeration Date	:	06/06/2012
Last Update Date	:	11/27/2018

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Directions to “ ANNA ELLENBERGER DPT” Practice Location

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