MEDICARE: ERIC KURZENBERGER MS, OTR/L, CBIS, ATP

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	OT10847	CA

General Provider Information

NPI Number	:	1780919803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC KURZENBERGER MS, OTR/L, CBIS, ATP

Provider Business Mailing Address
First Line	:	3109 WELSH RD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19136-1916
Country	:	US
Telephone Number	:	215-335-5590
Fax Number	:

Provider Business Practice Location Address
First Line	:	3109 WELSH RD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19136-1916
Country	:	US
Telephone Number	:	215-335-5590
Fax Number	:

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

Provider Enumeration Date	:	10/07/2009
Last Update Date	:	10/07/2009

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