Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | OC008692 | PA |
NPI | 1437557659 |
---|---|
Provider Name | Timothy Hungaski |
First Address | Kempton, PA 19529-8907 |
Second Address | Kempton, PA 19529-8907 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2014 |
Last Update Date | 22/12/2014 |