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NPI Code Detail

MEDICARE: DENISE REDENSKI OTR/L

MEDICARE: DENISE REDENSKI OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistOC005732LPA
2225XP0019XPhysical Rehabilitation Occupational TherapistOC005732LPA

General Provider Information

NPI Number : 1073148706
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENISE REDENSKI OTR/L
Provider Business Mailing Address
First Line : 165 STATE ST
Second Line :
City : NANTICOKE
State : PA
Zip : 18634-2337
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1111 E END BLVD
Second Line :
City : WILKES BARRE
State : PA
Zip : 18711-0026
Country : US
Telephone Number : 570-824-3521
Fax Number : 570-819-5143
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2020
Last Update Date : 03/03/2020

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Directions to “ DENISE REDENSKI OTR/L” Practice Location

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