Healthcare Provider Details

I. General information

NPI: 1912682725
Provider Name (Legal Business Name): KATHRYN ELIZABETH HURLEY OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2023
Last Update Date: 06/19/2023
Certification Date: 06/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5364 JACKSON ST
PHILADELPHIA PA
19124-1565
US

IV. Provider business mailing address

1317 THOMSON RD
ABINGTON PA
19001-3016
US

V. Phone/Fax

Practice location:
  • Phone: 860-605-5467
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOC016330
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: