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General NPI Number Information
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NPI Number | 1780576686
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Entity Type | Individual
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Provider Name | VIRGINIA EILEEN KOENIG OTD, MSA, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 07/16/2025
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 64 RIDGWAY DR STE 1
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City | DALLAS
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State | PA
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Zip | 18612-9263
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Country | US
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Telephone | 570-255-4578
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Fax | 570-255-4575
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Provider Business Mailing Address
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Address Line | 1036 DEWBERRY DR
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City | HAWLEY
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State | PA
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Zip | 18428-8324
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Country | US
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Telephone | 516-446-0082
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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 | OC020618
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License Number State | PA
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