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NPI Code Detail

MEDICARE: RICHARD CHOWANEC OTA/L

MEDICARE: RICHARD CHOWANEC OTA/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
1224Z00000XOccupational Therapy AssistantOP-000987LPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
210182OTHERPAFACILITY LICENSE NUMBER
31831498567OTHERPANPI

General Provider Information

NPI Number : 1174931984
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD CHOWANEC OTA/L
Provider Business Mailing Address
First Line : 1404 GOLF PARK DR
Second Line :
City : LAKE ARIEL
State : PA
Zip : 18436-4252
Country : US
Telephone Number : 570-698-5647
Fax Number : 570-698-7742
Provider Business Practice Location Address
First Line : 1404 GOLF PARK DR
Second Line :
City : LAKE ARIEL
State : PA
Zip : 18436-4252
Country : US
Telephone Number : 570-698-5647
Fax Number : 570-698-7742
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2014
Last Update Date : 07/24/2014

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Directions to “ RICHARD CHOWANEC OTA/L” Practice Location

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