Provider Demographics
NPI:1881018240
Name:FEATHERSTON, LAUREN (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:
Last Name:FEATHERSTON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:178 BEACH 138TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLE HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1338
Mailing Address - Country:US
Mailing Address - Phone:908-723-0428
Mailing Address - Fax:
Practice Address - Street 1:1800 ANDREWS AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-5202
Practice Address - Country:US
Practice Address - Phone:908-723-0428
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-05
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018411-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist