Provider Demographics
NPI:1821135401
Name:PLITT WARREN, LOIS (MPS, ATR-BC, LCAT)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:
Last Name:PLITT WARREN
Suffix:
Gender:F
Credentials:MPS, ATR-BC, LCAT
Other - Prefix:
Other - First Name:LOIS
Other - Middle Name:PLITT
Other - Last Name:WARREN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MPS, ATR-BC,LCAT
Mailing Address - Street 1:211 BROADWAY
Mailing Address - Street 2:207
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-3290
Mailing Address - Country:US
Mailing Address - Phone:516-967-7530
Mailing Address - Fax:
Practice Address - Street 1:211 BROADWAY STE 207
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-3290
Practice Address - Country:US
Practice Address - Phone:516-967-7530
Practice Address - Fax:516-825-6567
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2021-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000625221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist