Basic Information
| Provider Information | |||||||||
| NPI: | 1558743211 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DIGAETANO | ||||||||
| FirstName: | KRISTINA | ||||||||
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| Credential: | OT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3809 WEST CHESTER PIKE | ||||||||
| Address2: | 150 | ||||||||
| City: | NEWTOWN SQUARE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19073 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103595661 | ||||||||
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| Practice Location | |||||||||
| Address1: | 300 EVERGREEN DRIVE | ||||||||
| Address2: | SUITE 220 | ||||||||
| City: | GLEN MILLS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 19342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6105793650 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2015 | ||||||||
| LastUpdateDate: | 06/18/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OC013899 | PA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.