Provider Demographics
NPI:1508987025
Name:MARY E. YENKOWSKI
Entity Type:Organization
Organization Name:MARY E. YENKOWSKI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:YENKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MS OT
Authorized Official - Phone:610-509-1340
Mailing Address - Street 1:1769 33RD ST SW
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-6453
Mailing Address - Country:US
Mailing Address - Phone:601-509-1340
Mailing Address - Fax:
Practice Address - Street 1:1175 MOSSER RD.
Practice Address - Street 2:
Practice Address - City:TREXLERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18087
Practice Address - Country:US
Practice Address - Phone:610-395-5661
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC009463225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty