Provider Demographics
NPI:1558678003
Name:LEVINE-ROSTOWSKY, LISA ROBYN (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:ROBYN
Last Name:LEVINE-ROSTOWSKY
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 1:7 HICKORY HILLS CT
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1647
Mailing Address - Country:US
Mailing Address - Phone:732-673-2570
Mailing Address - Fax:
Practice Address - Street 1:7 HICKORY HILLS CT
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1647
Practice Address - Country:US
Practice Address - Phone:732-673-2570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-04
Last Update Date:2010-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3112225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist