Provider Demographics
NPI:1598712408
Name:KOSITS-DEMARCO, ADRIANA LYNN (OT)
Entity Type:Individual
Prefix:
First Name:ADRIANA
Middle Name:LYNN
Last Name:KOSITS-DEMARCO
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 1:2 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MARCUS HOOK
Mailing Address - State:PA
Mailing Address - Zip Code:19061-4513
Mailing Address - Country:US
Mailing Address - Phone:610-859-8850
Mailing Address - Fax:610-859-7876
Practice Address - Street 1:1651 53 PULASKI HWY
Practice Address - Street 2:
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-1453
Practice Address - Country:US
Practice Address - Phone:302-834-1550
Practice Address - Fax:302-834-1549
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEU10000809225X00000X
PAOC008864225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3780952000OtherINDEPENDENCE BLUE CROSS
DEP00359624OtherMEDICARE RAILROAD
PA102556918-0001Medicaid
DE1598712408Medicaid
DE000051060OtherDPCI
PA2141327OtherHIGHMARK BLUE SHIELD
PA2141327OtherHIGHMARK BLUE SHIELD
DE1598712408Medicaid
PA3780952000OtherINDEPENDENCE BLUE CROSS
P83877Medicare UPIN