NPIMap

Lisa Digiondomenico Agatone, O.T.

Individual provider Active NPI Occupational Therapist · Blue Bell, PA

NPI 1033429477 · NPPES record last updated Oct 20, 2010

Key facts

NPI
1033429477
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
OC006523L (PA)
Practice address
1515 Dekalb Pike
Suite 100
Blue Bell, PA 19422-3367
Phone
(610) 277-1990
Fax
(610) 277-2007
NPI assigned
Oct 19, 2010
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
OC006523LPAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Montgomery County Hand Center Inc Occupational Therapist Past
since Jan 2, 2012		 Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OC006523L PA Yes

Addresses

Primary practice location

1515 Dekalb Pike
Suite 100
Blue Bell, PA 19422-3367

Mailing address

1515 Dekalb Pike
Suite 100
Blue Bell, PA 19422-3367
Phone (610) 277-1990

Other providers in Blue Bell, PA

All providers in Blue Bell, PA · Occupational Therapist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.