Provider Demographics
NPI:1619690120
Name:LIUZZI, CARMELINA LYNNE (COTA/L, OT)
Entity Type:Individual
Prefix:
First Name:CARMELINA
Middle Name:LYNNE
Last Name:LIUZZI
Suffix:
Gender:F
Credentials:COTA/L, OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 SEMINOLE AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-2523
Mailing Address - Country:US
Mailing Address - Phone:518-669-6834
Mailing Address - Fax:
Practice Address - Street 1:4988 NY 30
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010
Practice Address - Country:US
Practice Address - Phone:518-842-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-20
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPENDING225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist