Provider Demographics
NPI:1356795017
Name:FRLIC, PAOLO (OTR)
Entity type:Individual
Prefix:
First Name:PAOLO
Middle Name:
Last Name:FRLIC
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18022 UNION TPKE
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366-1620
Mailing Address - Country:US
Mailing Address - Phone:718-380-8300
Mailing Address - Fax:718-380-8303
Practice Address - Street 1:18022 UNION TPKE
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1620
Practice Address - Country:US
Practice Address - Phone:718-380-8300
Practice Address - Fax:718-380-8303
Is Sole Proprietor?:No
Enumeration Date:2016-04-19
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019827-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist