MEDICARE: JULIA PAIGE VELLKY OTD OTR/L

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	OC017740	PA

General Provider Information

NPI Number	:	1801463674
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA PAIGE VELLKY OTD OTR/L

Provider Business Mailing Address
First Line	:	114 OLYMPIA ST APT 1
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15211-1347
Country	:	US
Telephone Number	:	614-949-6730
Fax Number	:

Provider Business Practice Location Address
First Line	:	3399 BRODHEAD RD
Second Line	:
City	:	ALIQUIPPA
State	:	PA
Zip	:	15001-1261
Country	:	US
Telephone Number	:	724-888-2548
Fax Number	:

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

Provider Enumeration Date	:	06/09/2021
Last Update Date	:	06/09/2021

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