Provider Demographics
NPI:1902042070
Name:SPILABOTTE, LORI ANN (PT)
Entity Type:Individual
Prefix:MRS
First Name:LORI ANN
Middle Name:
Last Name:SPILABOTTE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1583 TULIP AVE
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-1128
Mailing Address - Country:US
Mailing Address - Phone:516-385-1786
Mailing Address - Fax:
Practice Address - Street 1:1583 TULIP AVE
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-1128
Practice Address - Country:US
Practice Address - Phone:516-385-1786
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-19
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019915225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist