Provider Demographics
NPI:1013160092
Name:TULEVSKI, LISA MARIE (LISA TULEVSKI, OTR)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:MARIE
Last Name:TULEVSKI
Suffix:
Gender:F
Credentials:LISA TULEVSKI, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 S BROADWAY
Mailing Address - Street 2:APARTMENT 3F
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-1467
Mailing Address - Country:US
Mailing Address - Phone:516-435-8640
Mailing Address - Fax:
Practice Address - Street 1:111 S BROADWAY
Practice Address - Street 2:APARTMENT 3F
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-1467
Practice Address - Country:US
Practice Address - Phone:516-435-8640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010013225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist