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NPI Code Detail

MEDICARE: MRS. ADRIEN LEIGH PEDERSON OTR

MEDICARE: MRS. ADRIEN LEIGH PEDERSON OTR
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
1225X00000XOccupational TherapistOC010236PA

General Provider Information

NPI Number : 1255457354
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ADRIEN LEIGH PEDERSON OTR
Provider Business Mailing Address
First Line : 4001 STONECREEK LN
Second Line :
City : WASHINGTON
State : PA
Zip : 15301-5016
Country : US
Telephone Number : 724-809-7103
Fax Number :
Provider Business Practice Location Address
First Line : 3590 WASHINGTON PIKE
Second Line :
City : BRIDGEVILLE
State : PA
Zip : 15017-1047
Country : US
Telephone Number : 412-257-2474
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2007
Last Update Date : 07/08/2007

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