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NPI Code Detail

MEDICARE: CAROLINE STUART GREEN OTR/L

MEDICARE: CAROLINE STUART GREEN 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 TherapistOC013578PA

General Provider Information

NPI Number : 1407259237
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLINE STUART GREEN OTR/L
Provider Business Mailing Address
First Line : 815 CHESTER PIKE
Second Line :
City : PROSPECT PARK
State : PA
Zip : 19076-2322
Country : US
Telephone Number : 610-586-6262
Fax Number :
Provider Business Practice Location Address
First Line : 815 CHESTER PIKE
Second Line :
City : PROSPECT PARK
State : PA
Zip : 19076-2322
Country : US
Telephone Number : 610-586-6262
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2014
Last Update Date : 10/07/2014

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Directions to “ CAROLINE STUART GREEN OTR/L” Practice Location

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