Provider Demographics
NPI:1316127723
Name:WEISMAN, DENISE LORE (BS)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:LORE
Last Name:WEISMAN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:513 LEXINGTON LN
Mailing Address - Street 2:
Mailing Address - City:EAGLEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19403-1206
Mailing Address - Country:US
Mailing Address - Phone:610-630-6621
Mailing Address - Fax:610-630-6470
Practice Address - Street 1:3075 RIDGW AVE
Practice Address - Street 2:MARC
Practice Address - City:EAGLEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19403-1206
Practice Address - Country:US
Practice Address - Phone:610-265-4700
Practice Address - Fax:610-265-3439
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOC001384L225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics