Provider Demographics
NPI:1811021660
Name:STUBIN-AMELIO, LORA ANN (MA, OTR, CHT)
Entity Type:Individual
Prefix:
First Name:LORA
Middle Name:ANN
Last Name:STUBIN-AMELIO
Suffix:
Gender:F
Credentials:MA, OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 E 89TH ST
Mailing Address - Street 2:#4C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-2305
Mailing Address - Country:US
Mailing Address - Phone:212-876-6996
Mailing Address - Fax:212-987-8124
Practice Address - Street 1:525 E 68TH ST
Practice Address - Street 2:142A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4870
Practice Address - Country:US
Practice Address - Phone:212-746-1546
Practice Address - Fax:212-746-1611
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0045821225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist