Provider Demographics
NPI:1770884777
Name:MCGINN, LORRAINE (COTA)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:
Last Name:MCGINN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:LORRAINE
Other - Middle Name:
Other - Last Name:ENGELHART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:38 EDWARDS PL
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTN STA
Mailing Address - State:NY
Mailing Address - Zip Code:11746-1014
Mailing Address - Country:US
Mailing Address - Phone:631-219-5291
Mailing Address - Fax:631-351-1216
Practice Address - Street 1:72 S WOODS RD
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-1024
Practice Address - Country:US
Practice Address - Phone:516-921-7650
Practice Address - Fax:516-364-4258
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-06
Last Update Date:2010-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005844-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant