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General NPI Number Information
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NPI Number | 1629540067
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Entity Type | Individual
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Provider Name | WILFREDO LAZARUS DONES OTR/L, MSOT
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Gender | Male
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Dates
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Enumeration Date | 12/25/2018
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Last Update Date | 12/25/2018
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Provider Practice Location Address
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Address Line | 701 SLATE BELT BLVD
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City | BANGOR
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State | PA
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Zip | 18013-9341
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Country | US
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Telephone | 610-588-6161
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Fax |
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Provider Business Mailing Address
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Address Line | 61 BEAVER DR
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City | ALBRIGHTSVILLE
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State | PA
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Zip | 18210-3844
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Country | US
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Telephone | 570-972-7625
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | OC015762
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License Number State | PA
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