| Empirical Pediatric Therapy, Inc. | |
|
413 Fairmount Ave # 1 Philadelphia PA 19123-2807 | |
| (267) 908-7772 | |
| Not Available |
| Full Name | Empirical Pediatric Therapy, Inc. |
|---|---|
| Speciality | Occupational Therapist |
| Location | 413 Fairmount Ave # 1, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Jaisen Stango (VICE PRESIDENT) |
| Authorized Official Contact | 2679087772 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Empirical Pediatric Therapy, Inc. 702 N 3rd St Pmb 854 Philadelphia PA 19123 Ph: (267) 908-7772 | Empirical Pediatric Therapy, Inc. 413 Fairmount Ave # 1 Philadelphia PA 19123-2807 Ph: (267) 908-7772 |
| NPI Number | 1437662814 |
|---|---|
| Provider Enumeration Date | 11/08/2017 |
| Last Update Date | 11/08/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437662814 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | BH002146 (Pennsylvania) | Secondary |
| 225X00000X | Occupational Therapist | OC010741 (Pennsylvania) | Primary |
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