Provider Demographics
NPI:1932516234
Name:ARLINE, LUCIUS
Entity Type:Individual
Prefix:
First Name:LUCIUS
Middle Name:
Last Name:ARLINE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 WEST 142ND ST
Mailing Address - Street 2:APT 11G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037
Mailing Address - Country:US
Mailing Address - Phone:121-242-3864
Mailing Address - Fax:
Practice Address - Street 1:1901 1ST AVE
Practice Address - Street 2:OCCUPATIONAL THERAPY 3A UNIT
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-7404
Practice Address - Country:US
Practice Address - Phone:212-423-8644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-18
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018565225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist