Provider Demographics
NPI:1033103965
Name:NAUGHTON, NANCY (OT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:NAUGHTON
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 1:109 TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:OLYPHANT
Mailing Address - State:PA
Mailing Address - Zip Code:18447-2501
Mailing Address - Country:US
Mailing Address - Phone:570-483-4603
Mailing Address - Fax:570-319-1250
Practice Address - Street 1:109 TERRACE DR
Practice Address - Street 2:
Practice Address - City:OLYPHANT
Practice Address - State:PA
Practice Address - Zip Code:18447-2501
Practice Address - Country:US
Practice Address - Phone:570-483-4603
Practice Address - Fax:570-319-1250
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC001670L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA7688340OtherAETNA
PAWE101885OtherPENNA BLUE SHIELD
PA001898935Medicaid
PA66866-159BOtherGEISINGER HEALTH PLAN
PA814853OtherFIRST PRIORITY HEALTH
PA2817776OtherUS HEALTHCARE
PA670001863OtherRAILROAD MEDICARE
P48089Medicare UPIN
PA053953PFFMedicare ID - Type Unspecified