Provider Demographics
NPI:1831198605
Name:VAN DRIESEN, DENICE E (OTR/L)
Entity type:Individual
Prefix:
First Name:DENICE
Middle Name:E
Last Name:VAN DRIESEN
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 1:2775 SCHOENERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-7307
Mailing Address - Country:US
Mailing Address - Phone:610-861-8080
Mailing Address - Fax:610-807-0366
Practice Address - Street 1:2775 SCHOENERSVILLE RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7307
Practice Address - Country:US
Practice Address - Phone:610-861-8080
Practice Address - Fax:610-807-0366
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC002857L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0422737000OtherKEYSTONE HEALTH EAST
2420161OtherCIGNA HEALTHCARE
0422737000OtherINDEPENDENCE BLUE CROSS
2170728OtherMAMSI
0422737000OtherAMERIHEALTH
2202022OtherUNITED HEALTHCARE
821772OtherFIRST PRIORITY HEALTH
47241OtherGEISINGER HEALTH PLAN
962641OtherHIGHMARK BLUE SHIELD
02223802OtherCAPITAL BLUE CROSS
850162OtherAETNA PPO
315283OtherHEALTHAMERICA/HEALTHASSUR
02223802OtherKEYSTONE HEALTH CENTRAL
P1643788OtherOXFORD HEALTH PLANS
850162OtherAETNA PPO
02223802OtherKEYSTONE HEALTH CENTRAL