Provider Demographics
NPI:1942736624
Name:FABRIZIO, LAUREN (MPS, ATR-BC, LCAT)
Entity Type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:
Last Name:FABRIZIO
Suffix:
Gender:F
Credentials:MPS, ATR-BC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 MADISON AVE
Mailing Address - Street 2:10L
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2820
Mailing Address - Country:US
Mailing Address - Phone:631-848-4123
Mailing Address - Fax:
Practice Address - Street 1:240 MADISON AVE
Practice Address - Street 2:10L
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2820
Practice Address - Country:US
Practice Address - Phone:631-848-4123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-02
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001474-1221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist