Healthcare Provider Details

I. General information

NPI: 1164725693
Provider Name (Legal Business Name): ELIZABETH ARANA MESTER OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2010
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CRESCENT DR STE 100
PHILADELPHIA PA
19112-1015
US

IV. Provider business mailing address

PO BOX 34990
BELFAST ME
04915-0627
US

V. Phone/Fax

Practice location:
  • Phone: 215-521-3023
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License NumberOC011441
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: