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NPI Code Detail

MEDICARE: MARTHA EPPINGER NICHOLS OTR

MEDICARE: MARTHA EPPINGER NICHOLS OTR
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 Therapist46TR00211100NJ
2225X00000XOccupational TherapistOC001944LPA

General Provider Information

NPI Number : 1326268368
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARTHA EPPINGER NICHOLS OTR
Provider Business Mailing Address
First Line : 1801 MITMAN RD
Second Line :
City : EASTON
State : PA
Zip : 18040-8249
Country : US
Telephone Number : 610-253-3462
Fax Number :
Provider Business Practice Location Address
First Line : 290 RED SCHOOL LN
Second Line :
City : PHILLIPSBURG
State : NJ
Zip : 08865-2276
Country : US
Telephone Number : 908-859-2800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2007
Last Update Date : 07/08/2007

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