Provider Demographics
NPI:1659705788
Name:FARRUGGIA, LAURA MARGARET (COTA)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MARGARET
Last Name:FARRUGGIA
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10596 S STREET RD
Mailing Address - Street 2:
Mailing Address - City:LE ROY
Mailing Address - State:NY
Mailing Address - Zip Code:14482-8927
Mailing Address - Country:US
Mailing Address - Phone:585-746-8211
Mailing Address - Fax:
Practice Address - Street 1:10596 S STREET RD
Practice Address - Street 2:
Practice Address - City:LE ROY
Practice Address - State:NY
Practice Address - Zip Code:14482-8927
Practice Address - Country:US
Practice Address - Phone:585-746-8211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004075-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant