Provider Demographics
NPI:1225494461
Name:KARAMANIDES, DIMITRA (OTR/L)
Entity Type:Individual
Prefix:
First Name:DIMITRA
Middle Name:
Last Name:KARAMANIDES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:849 BRYN MAWR AVE
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-4334
Mailing Address - Country:US
Mailing Address - Phone:505-205-5465
Mailing Address - Fax:
Practice Address - Street 1:849 BRYN MAWR AVE
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-4334
Practice Address - Country:US
Practice Address - Phone:505-205-5465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-01-04
Last Update Date:2016-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC013586225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation