| Doctor Name: | IVY REROMA |
| NPI Number: | 1316235708 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | OTR/L |
| License Number: | OC011914 |
| Business Practice Address: | 3201 Cheltenham Ave Wyncote, PA - 190952900 |
| Business Phone Number: | 2155177551 |
| Business Fax Number: | |
| Mailing Address: | 3201 Cheltenham Ave, WYNCOTE |
| State: | PA |
| Postal Code: | 190952900 |
| Phone Number: | 2155177551 |
| Fax Number: | |
| NPI Enumeration Date: | 07/19/2011 |
| NPI Last Update Date: | 07/19/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225XH1200X |
| License Number: | OC011914 |
| 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: | |