Provider Demographics
NPI:1518953751
Name:KUNKLE, CHERYL B (OT)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:B
Last Name:KUNKLE
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:PO BOX 848269
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02284-8269
Mailing Address - Country:US
Mailing Address - Phone:610-973-1700
Mailing Address - Fax:610-973-1778
Practice Address - Street 1:798 HAUSMAN RD STE 200
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9179
Practice Address - Country:US
Practice Address - Phone:610-391-9000
Practice Address - Fax:610-391-9001
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC001329L225X00000X, 225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA5483080OtherAETNA
PA02183701OtherBLUE CROSS
PA02183701OtherKEYSTONE CENTRAL
PA5483080OtherAETNA