Provider Demographics
NPI:1639139009
Name:PITMAN, JEANETTE C (OT)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:C
Last Name:PITMAN
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 1:393 TOWNSHIP LINE RD
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-1428
Mailing Address - Country:US
Mailing Address - Phone:215-340-2216
Mailing Address - Fax:
Practice Address - Street 1:924 TOWN CTR
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:PA
Practice Address - Zip Code:18901-5182
Practice Address - Country:US
Practice Address - Phone:215-340-2216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC000928L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01525923Medicaid
PA30013760OtherKEYSTONE MERCY HEALTH PLA
PA757591OtherBLUE CROSS BLUE SHIELD