Provider Demographics
NPI:1982018214
Name:ROSALIE LANZISERA PEDIATRIC OCCUPATIONAL THERAPIST, PC
Entity Type:Organization
Organization Name:ROSALIE LANZISERA PEDIATRIC OCCUPATIONAL THERAPIST, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ROSALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LANZISERA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:347-587-3124
Mailing Address - Street 1:60 OCEANA DR W
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6662
Mailing Address - Country:US
Mailing Address - Phone:347-587-3124
Mailing Address - Fax:347-587-3124
Practice Address - Street 1:60 OCEANA DR W
Practice Address - Street 2:SUITE 2B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6662
Practice Address - Country:US
Practice Address - Phone:347-587-3124
Practice Address - Fax:347-587-3124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-14
Last Update Date:2014-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007486251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health