Provider Demographics
NPI:1841377801
Name:KRESSE, DAVID CARL (OTR)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:CARL
Last Name:KRESSE
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 MERION DR
Mailing Address - Street 2:
Mailing Address - City:SINKING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:19608
Mailing Address - Country:US
Mailing Address - Phone:610-927-2665
Mailing Address - Fax:
Practice Address - Street 1:9 BRISTOL CT
Practice Address - Street 2:CENTER FOR PEDIATRIC THERAPY
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610
Practice Address - Country:US
Practice Address - Phone:610-670-8600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC009036225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1767830OtherHIGHMARK PROVIDER #