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General NPI Number Information
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NPI Number | 1639978430
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Entity Type | Individual
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Provider Name | HANNAH BROOMALL OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 03/12/2025
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 200 CENTRAL AVE
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City | FARMINGDALE
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State | NJ
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Zip | 07727-3788
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Country | US
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Telephone | 215-839-6144
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Fax |
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Provider Business Mailing Address
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Address Line | 235 BROWN ST
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City | PHILADELPHIA
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State | PA
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Zip | 19123-2232
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Country | US
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Telephone | 302-584-7504
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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 | OC020443
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License Number State | PA
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