Provider Demographics
NPI:1417401241
Name:PECORA, LYNN (OT)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:PECORA
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 1:23 N SPRING GARDEN ST
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-4512
Mailing Address - Country:US
Mailing Address - Phone:215-641-4626
Mailing Address - Fax:215-641-4626
Practice Address - Street 1:23 N SPRING GARDEN ST
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-4512
Practice Address - Country:US
Practice Address - Phone:215-641-4626
Practice Address - Fax:215-641-4626
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC001349L225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation