Provider Demographics
NPI:1790071983
Name:BELTRAN-CORREALE, LORENA MARIA (OT)
Entity Type:Individual
Prefix:MRS
First Name:LORENA
Middle Name:MARIA
Last Name:BELTRAN-CORREALE
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-4128
Mailing Address - Country:US
Mailing Address - Phone:516-225-1018
Mailing Address - Fax:
Practice Address - Street 1:750 HICKSVILLE RD
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:NY
Practice Address - Zip Code:11783-1328
Practice Address - Country:US
Practice Address - Phone:516-520-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-26
Last Update Date:2011-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP78767225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics