Provider Demographics
NPI:1184023285
Name:BIELANSKI, KEVIN MICHAEL (OTD, MED, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:MICHAEL
Last Name:BIELANSKI
Suffix:
Gender:M
Credentials:OTD, MED, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30112 BIG MARSH CT UNIT 6602
Mailing Address - Street 2:
Mailing Address - City:OCEAN VIEW
Mailing Address - State:DE
Mailing Address - Zip Code:19970-3891
Mailing Address - Country:US
Mailing Address - Phone:908-752-8210
Mailing Address - Fax:
Practice Address - Street 1:30112 BIG MARSH CT UNIT 6602
Practice Address - Street 2:
Practice Address - City:OCEAN VIEW
Practice Address - State:DE
Practice Address - Zip Code:19970-3891
Practice Address - Country:US
Practice Address - Phone:908-752-8210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU1-0001411225X00000X
NJ46TR00599200225X00000X
NY017652225X00000X
PAOC012563225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist