Provider Demographics
NPI:1962536243
Name:GARCIA-HOMMEL, CARMEN (OT)
Entity type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:
Last Name:GARCIA-HOMMEL
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 N QUEEN ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3512
Mailing Address - Country:US
Mailing Address - Phone:717-291-5951
Mailing Address - Fax:717-291-9183
Practice Address - Street 1:244 N QUEEN ST
Practice Address - Street 2:UITE TWO
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-3512
Practice Address - Country:US
Practice Address - Phone:717-291-5951
Practice Address - Fax:717-291-9183
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC003272L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0256101OtherORTHONET
PA090564QKZMedicare ID - Type UnspecifiedMEDICARE
PA3793385OtherCIGNA