Provider Demographics
NPI:1134861628
Name:KEYSER, LYNDSEY NICOLE (COTA/L)
Entity type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:NICOLE
Last Name:KEYSER
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12721-4302
Mailing Address - Country:US
Mailing Address - Phone:845-741-8242
Mailing Address - Fax:
Practice Address - Street 1:58 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:BLOOMINGBURG
Practice Address - State:NY
Practice Address - Zip Code:12721-4302
Practice Address - Country:US
Practice Address - Phone:845-741-8242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-13
Last Update Date:2022-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011059224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant