Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | OC013586 | PA |
NPI | 1225494461 |
---|---|
Provider Name | Dimitra Karamanides |
First Address | Newtown Square, PA 19073-4334 |
Second Address | Newtown Square, PA 19073-4334 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2016 |
Last Update Date | 04/01/2016 |