Provider Demographics
NPI:1205834298
Name:VANLEER, POLLENE (OT)
Entity type:Individual
Prefix:
First Name:POLLENE
Middle Name:
Last Name:VANLEER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:520 PHILADELPHIA ST
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-3902
Mailing Address - Country:US
Mailing Address - Phone:724-463-7478
Mailing Address - Fax:724-463-0931
Practice Address - Street 1:400 MAIN ST
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-3810
Practice Address - Country:US
Practice Address - Phone:610-935-1120
Practice Address - Fax:610-935-5507
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2010-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA164224OtherHIGHMARK BLUE SHIELD
PA256072OtherHEALTH AMERICA-ASSURANCE
PA0164718000OtherINDEPENDENCE BLUE CROSS
44997G3DMedicare ID - Type Unspecified
PA256072OtherHEALTH AMERICA-ASSURANCE