Provider Demographics
NPI:1639380462
Name:MERONEY, SANDRA J (OTR)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:J
Last Name:MERONEY
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 1:455 SOUTH GULPH ROAD
Mailing Address - Street 2:EXECUTIVE TERRACE, SUITE 230
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-2900
Mailing Address - Country:US
Mailing Address - Phone:610-992-0555
Mailing Address - Fax:610-992-1010
Practice Address - Street 1:455 S GULPH RD
Practice Address - Street 2:EXECUTIVE TERRACE, SUITE 230
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-3114
Practice Address - Country:US
Practice Address - Phone:610-992-0555
Practice Address - Fax:610-992-1010
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC005669L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist