Provider Demographics
NPI:1508987579
Name:KAZMAN, WENDY HELENE (OTR)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:HELENE
Last Name:KAZMAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1457 NEWMAN RD
Mailing Address - Street 2:
Mailing Address - City:PENNSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18073-1978
Mailing Address - Country:US
Mailing Address - Phone:610-952-1039
Mailing Address - Fax:
Practice Address - Street 1:1457 NEWMAN RD
Practice Address - Street 2:
Practice Address - City:PENNSBURG
Practice Address - State:PA
Practice Address - Zip Code:18073-1978
Practice Address - Country:US
Practice Address - Phone:610-952-1039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC000294L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1009015650002Medicaid