Provider Demographics
NPI:1083693824
Name:LUCCHI-CAPONIGRO, LORI (OTR/L)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:LUCCHI-CAPONIGRO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 GOLDEN RD
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-3219
Mailing Address - Country:US
Mailing Address - Phone:845-368-8582
Mailing Address - Fax:
Practice Address - Street 1:151 N MAIN ST
Practice Address - Street 2:SUITE 302
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3851
Practice Address - Country:US
Practice Address - Phone:845-638-2728
Practice Address - Fax:845-638-1830
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3541225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ58361Medicare PIN