Provider Demographics
NPI:1255488094
Name:THORPE, LISA F (OTR)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:F
Last Name:THORPE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MISS
Other - First Name:LISA
Other - Middle Name:F
Other - Last Name:FEDERIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:2994 STONY POINT RD
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14072-1495
Mailing Address - Country:US
Mailing Address - Phone:716-773-4416
Mailing Address - Fax:
Practice Address - Street 1:3925 SHERIDAN DRIVE
Practice Address - Street 2:SUITE 120
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-0000
Practice Address - Country:US
Practice Address - Phone:716-250-6500
Practice Address - Fax:716-250-4177
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005506225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist