Provider Demographics
NPI:1881101863
Name:ROTHMAN, LORI JILL (OTR)
Entity type:Individual
Prefix:MS
First Name:LORI
Middle Name:JILL
Last Name:ROTHMAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MISS
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:NITZBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:14 NUTTER WAY
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-9343
Mailing Address - Country:US
Mailing Address - Phone:917-596-6351
Mailing Address - Fax:
Practice Address - Street 1:14 NUTTER WAY
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-9343
Practice Address - Country:US
Practice Address - Phone:917-596-6351
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-29
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001622-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics