Basic Information
Provider Information
NPI: 1043461643
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KREMER
FirstName: ELLEN
MiddleName: R H
NamePrefix: MS.
NameSuffix:  
Credential: M.S., OTR/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 235 W LANCASTER AVE
Address2:  
City: DEVON
State: PA
PostalCode: 193331560
CountryCode: US
TelephoneNumber: 6106888080
FaxNumber:  
Practice Location
Address1: 235 W LANCASTER AVE
Address2:  
City: DEVON
State: PA
PostalCode: 193331560
CountryCode: US
TelephoneNumber: 6106888080
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/02/2008
LastUpdateDate: 10/02/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000XOC000987LPAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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