MEDICARE: JAMIE DULLINGER MOT, 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
1	225X00000X	Occupational Therapist	OC015241	PA

General Provider Information

NPI Number	:	1265943823
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE DULLINGER MOT, OTR/L

Provider Business Mailing Address
First Line	:	6627 RIDGEVILLE ST
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15217-1314
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	410 E 4TH AVE
Second Line	:
City	:	TARENTUM
State	:	PA
Zip	:	15084-1810
Country	:	US
Telephone Number	:	717-808-6169
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/22/2017
Last Update Date	:	10/22/2017

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