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NPI Code Detail

MEDICARE: KELLY BERGMAN OTD, OTR/L

MEDICARE:   KELLY  BERGMAN  OTD, 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 TherapistOC020853PA

General Provider Information

NPI Number : 1912721531
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY BERGMAN OTD, OTR/L
Provider Business Mailing Address
First Line : 105 SHAG BARK LN
Second Line :
City : VENETIA
State : PA
Zip : 15367-1157
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 300 HALKET ST
Second Line :
City : PITTSBURGH
State : PA
Zip : 15213-3108
Country : US
Telephone Number : 412-641-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2024
Last Update Date : 04/09/2026

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Directions to “ KELLY BERGMAN OTD, OTR/L” Practice Location

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