Provider Demographics
NPI:1144486382
Name:CIESIELSKI, LORI ANNE (MS, OTR/L)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:ANNE
Last Name:CIESIELSKI
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3727 HOWARD RD
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-2251
Mailing Address - Country:US
Mailing Address - Phone:716-648-5767
Mailing Address - Fax:
Practice Address - Street 1:1486 EGGERT RD
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-3359
Practice Address - Country:US
Practice Address - Phone:716-204-5925
Practice Address - Fax:716-204-5926
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007218-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health