Provider Demographics
NPI:1730654377
Name:FERESHETIAN, JOYCE NAZALEE (OTR/L)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:NAZALEE
Last Name:FERESHETIAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 BERKLEY PL
Mailing Address - Street 2:
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-4204
Mailing Address - Country:US
Mailing Address - Phone:518-396-6514
Mailing Address - Fax:
Practice Address - Street 1:6400 HULMEVILLE RD
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-1932
Practice Address - Country:US
Practice Address - Phone:215-752-1940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC015685225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist