Bergensten, Heather

Bergensten, Heather is an individual health care provider with primary practice located at 1404 Golf Park Dr , Lake Ariel PA 18436-4252. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Bergensten, Heather can be contacted via phone (570) 698-5647.

Contact Information

Primary practice address
1404 Golf Park Dr Lake Ariel PA 18436-4252
Phone: (570) 698-5647
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X OC010514 Pennsylvania

Profile Details

NPI number 1619385242
LBN Legal business name Bergensten, Heather
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2014
Last updated Jul 28th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619385242 NPPES
Pennsylvania MEDICAID 102602636-0001
Pennsylvania Other 101802

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