Provider Demographics
NPI:1134304777
Name:LINCOLN, NANCY (OTR)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:LINCOLN
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 1:8622 90TH ST FL 2
Mailing Address - Street 2:
Mailing Address - City:WOODHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11421-1332
Mailing Address - Country:US
Mailing Address - Phone:917-805-7688
Mailing Address - Fax:
Practice Address - Street 1:8622 90TH ST FL 2
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:NY
Practice Address - Zip Code:11421-1332
Practice Address - Country:US
Practice Address - Phone:917-805-7688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006627-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist