Provider Demographics
NPI:1932476231
Name:PICOZZI, LAURA (OT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:PICOZZI
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:RAVENNA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OT
Mailing Address - Street 1:612 CORPORATE WAY
Mailing Address - Street 2:SUITE 3M
Mailing Address - City:VALLEY COTTAGE
Mailing Address - State:NY
Mailing Address - Zip Code:10989-2021
Mailing Address - Country:US
Mailing Address - Phone:845-268-2323
Mailing Address - Fax:845-268-2360
Practice Address - Street 1:612 CORPORATE WAY
Practice Address - Street 2:SUITE 3M
Practice Address - City:VALLEY COTTAGE
Practice Address - State:NY
Practice Address - Zip Code:10989-2021
Practice Address - Country:US
Practice Address - Phone:845-268-2323
Practice Address - Fax:845-268-2360
Is Sole Proprietor?:No
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006688-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist