Provider Demographics
NPI:1639120652
Name:LETCAVAGE, NEIL B (OTR,CHT)
Entity Type:Individual
Prefix:MR
First Name:NEIL
Middle Name:B
Last Name:LETCAVAGE
Suffix:
Gender:M
Credentials:OTR,CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 S WARMINSTER RD
Mailing Address - Street 2:APT. F4
Mailing Address - City:HATBORO
Mailing Address - State:PA
Mailing Address - Zip Code:19040-4101
Mailing Address - Country:US
Mailing Address - Phone:215-674-2427
Mailing Address - Fax:215-674-2427
Practice Address - Street 1:101 PROGRESS DR
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2563
Practice Address - Country:US
Practice Address - Phone:215-489-8550
Practice Address - Fax:215-489-8554
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0C001375L225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand