Provider Demographics
NPI:1508911108
Name:CAMACHO-VASQUEZ, LORRAINE (OTR)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:
Last Name:CAMACHO-VASQUEZ
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 OXRIDGE ROAD
Mailing Address - Street 2:
Mailing Address - City:ELMSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10523
Mailing Address - Country:US
Mailing Address - Phone:718-960-2994
Mailing Address - Fax:
Practice Address - Street 1:10 OX RIDGE RD
Practice Address - Street 2:
Practice Address - City:ELMSFORD
Practice Address - State:NY
Practice Address - Zip Code:10523-1706
Practice Address - Country:US
Practice Address - Phone:718-960-2994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003093225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics