Provider Demographics
NPI:1891978284
Name:GRIFFEY, LAUREN SUE BIRD (OT)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:SUE BIRD
Last Name:GRIFFEY
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:SUE
Other - Last Name:BIRD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:PO BOX 1014
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-1014
Mailing Address - Country:US
Mailing Address - Phone:732-855-9751
Mailing Address - Fax:732-855-9755
Practice Address - Street 1:1 NARDONE PL
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-3514
Practice Address - Country:US
Practice Address - Phone:201-792-3840
Practice Address - Fax:201-792-7948
Is Sole Proprietor?:No
Enumeration Date:2007-12-09
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05878225X00000X
CT004217225X00000X
NJ46TR00495300225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ190801NXZMedicare PIN