Provider Demographics
NPI:1538389143
Name:MISHKIN, ROSALIND MARCIA (OTR)
Entity type:Individual
Prefix:
First Name:ROSALIND
Middle Name:MARCIA
Last Name:MISHKIN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1576 WILLOW POND DR
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-5796
Mailing Address - Country:US
Mailing Address - Phone:215-369-3284
Mailing Address - Fax:
Practice Address - Street 1:1630 W GIRARD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-1615
Practice Address - Country:US
Practice Address - Phone:215-787-9367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC001007L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist