Provider Demographics
NPI:1790837219
Name:BRAUNSTEIN, LAURIE (MA, OTR L)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:BRAUNSTEIN
Suffix:
Gender:F
Credentials:MA, OTR L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 DONNYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:DEMAREST
Mailing Address - State:NJ
Mailing Address - Zip Code:07627-1005
Mailing Address - Country:US
Mailing Address - Phone:201-767-4004
Mailing Address - Fax:201-767-4227
Practice Address - Street 1:220 KNICKERBOCKER RD
Practice Address - Street 2:
Practice Address - City:CRESSKILL
Practice Address - State:NJ
Practice Address - Zip Code:07626-1827
Practice Address - Country:US
Practice Address - Phone:201-541-9222
Practice Address - Fax:201-541-1711
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00187500225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics