Provider Demographics
NPI:1326347980
Name:IMBERMAN, PAULINE LOUISE (OTR/L)
Entity Type:Individual
Prefix:
First Name:PAULINE
Middle Name:LOUISE
Last Name:IMBERMAN
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 1:412 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-4410
Mailing Address - Country:US
Mailing Address - Phone:267-880-3356
Mailing Address - Fax:
Practice Address - Street 1:412 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4410
Practice Address - Country:US
Practice Address - Phone:267-880-3356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-22
Last Update Date:2019-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC004010L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist