MEDICARE: POLLENE VANLEER OT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XH1200X	Hand Occupational Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	164224	OTHER	PA	HIGHMARK BLUE SHIELD
2	256072	OTHER	PA	HEALTH AMERICA-ASSURANCE
3	0164718000	OTHER	PA	INDEPENDENCE BLUE CROSS

General Provider Information

NPI Number	:	1205834298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	POLLENE VANLEER OT

Provider Business Mailing Address
First Line	:	520 PHILADELPHIA ST
Second Line	:
City	:	INDIANA
State	:	PA
Zip	:	15701-3902
Country	:	US
Telephone Number	:	724-463-7478
Fax Number	:	724-463-0931

Provider Business Practice Location Address
First Line	:	400 MAIN ST
Second Line	:
City	:	PHOENIXVILLE
State	:	PA
Zip	:	19460-3810
Country	:	US
Telephone Number	:	610-935-1120
Fax Number	:	610-935-5507

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2005
Last Update Date	:	02/01/2010

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Directions to “ POLLENE VANLEER OT” Practice Location

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