Provider Demographics
NPI:1568614824
Name:SUGARMAN, LAURIE KIM (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:KIM
Last Name:SUGARMAN
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 1:254 S MAIN ST STE 400
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-3363
Mailing Address - Country:US
Mailing Address - Phone:845-548-8663
Mailing Address - Fax:
Practice Address - Street 1:254 S MAIN ST STE 400
Practice Address - Street 2:
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956
Practice Address - Country:US
Practice Address - Phone:845-548-8663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-17
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013616-1172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker