Provider Demographics
NPI:1245477793
Name:ACHESON, LAURA M (OTR)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:M
Last Name:ACHESON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MISS
Other - First Name:LAURA
Other - Middle Name:M
Other - Last Name:PELLICIONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:44 FLITT STREET
Mailing Address - Street 2:
Mailing Address - City:TAPPAN
Mailing Address - State:NY
Mailing Address - Zip Code:10983-2204
Mailing Address - Country:US
Mailing Address - Phone:845-365-6645
Mailing Address - Fax:
Practice Address - Street 1:25 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901
Practice Address - Country:US
Practice Address - Phone:845-357-4733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-20
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014795-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics