Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 45TR00351400 | NJ |
N | 225X00000X | Occupational Therapist | OC009216 | PA |
N | 225XH1200X | Occupational Therapist - Hand | 46TR00351400 | NJ |
Y | 225XH1200X | Occupational Therapist - Hand | OC009216 | PA |
NPI | 1053529461 |
---|---|
Provider Name | Ms. Lois A Digirolamo |
First Address | Philadelphia, PA 19107-5127 |
Second Address | Philadelphia, PA 19107-5127 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 23/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2829089000 | IBC - KEYSTONE (01) | PW |