=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316061146
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANET WEISMAN OT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/19/2007
-----------------------------------------------------
Last Update Date | 12/01/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 403 6TH ST 870
-----------------------------------------------------
City | HUNTINGDON
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 16652-1518
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-856-2738
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 36 PEBBLE DR
-----------------------------------------------------
City | HOLLAND
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18966-2832
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 267-364-5546
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | OC002313L
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------