Provider Demographics
NPI:1457506818
Name:PAULUCCI, LORRI S (OTR/L)
Entity Type:Individual
Prefix:
First Name:LORRI
Middle Name:S
Last Name:PAULUCCI
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 1:288 11TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3911
Mailing Address - Country:US
Mailing Address - Phone:917-403-3324
Mailing Address - Fax:
Practice Address - Street 1:288 11TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3911
Practice Address - Country:US
Practice Address - Phone:718-499-0193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009195-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY009195-1OtherSELF-EMPLOYED
NY225XPO200XOtherSELF-EMPLOYED