Provider Demographics
NPI:1700221470
Name:VARRIALE, LAUREN A (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:A
Last Name:VARRIALE
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:A
Other - Last Name:HEISLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS OTR/L
Mailing Address - Street 1:26 ADAMS PL
Mailing Address - Street 2:
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-1810
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:801 MERRICK AVE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-4748
Practice Address - Country:US
Practice Address - Phone:516-393-8900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014982-1225X00000X, 225XN1300X, 225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation