| Organization Name: | MAIN LINE HAND CENTER LLC |
| NPI Number: | 1043645948 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KAMALA N BONGIORNO (OWNER) |
| Mailing Address: | 250 W Lancaster Ave Suite 205 Paoli |
| State: | PA US |
| Postal Code: | 193011743 |
| Phone Number: | 6106518282 |
| Fax Number: | 6108518213 |
| NPI Enumeration Date: | 09/10/2013 |
| NPI Last Update Date: | 10/24/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225XH1200X |
| License Number: | OC001118L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Occupational Therapist |
| Taxonomy Specialization: | Hand |
| Taxonomy Definition: | |