Provider Demographics
NPI:1306904743
Name:MOYER, MELISSA (OT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:MOYER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:RITTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:924 TOWN CTR
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-5182
Mailing Address - Country:US
Mailing Address - Phone:215-340-2216
Mailing Address - Fax:
Practice Address - Street 1:924 TOWN CTR
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:PA
Practice Address - Zip Code:18901-5182
Practice Address - Country:US
Practice Address - Phone:215-340-2216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC008868225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1428076OtherBCBS
PA30013766Medicaid
PA01970653Medicaid
PA2424988OtherUNITED HEALTHCARE