Provider Demographics
NPI:1023302916
Name:ROHAN GRIFFIN, LAURI ANN (MS)
Entity type:Individual
Prefix:MRS
First Name:LAURI
Middle Name:ANN
Last Name:ROHAN GRIFFIN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:583 BARRACK HILL RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-2303
Mailing Address - Country:US
Mailing Address - Phone:203-431-6466
Mailing Address - Fax:
Practice Address - Street 1:1454 ROUTE 22
Practice Address - Street 2:SUITE B102
Practice Address - City:BREWSTER
Practice Address - State:NY
Practice Address - Zip Code:10509-4346
Practice Address - Country:US
Practice Address - Phone:845-279-5111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003296225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist