Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 000659-L | PA |
NPI | 1023603602 |
---|---|
Provider Name | Ms. Barbara M Cortellini-Benamy |
First Address | Springfield, PA 19064-2097 |
Second Address | Springfield, PA 19064-2097 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2021 |
Last Update Date | 04/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1457715146 | (05) | PA |