Provider Demographics
NPI:1952547762
Name:LANZISERA, ROSALIE (OTR)
Entity Type:Individual
Prefix:
First Name:ROSALIE
Middle Name:
Last Name:LANZISERA
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 1:1168 MIDDLETOWN LINCROFT RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-3217
Mailing Address - Country:US
Mailing Address - Phone:732-706-0922
Mailing Address - Fax:732-706-0922
Practice Address - Street 1:1168 MIDDLETOWN LINCROFT RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NJ
Practice Address - Zip Code:07748-3217
Practice Address - Country:US
Practice Address - Phone:732-706-0922
Practice Address - Fax:732-706-0922
Is Sole Proprietor?:No
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007486-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics