Provider Demographics
NPI:1952613010
Name:CARNEY, LAUREN CAIAZZO (OTR/L)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:CAIAZZO
Last Name:CARNEY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 BEACH 122ND ST
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1826
Mailing Address - Country:US
Mailing Address - Phone:718-634-0364
Mailing Address - Fax:
Practice Address - Street 1:447 BEACH 122ND ST
Practice Address - Street 2:
Practice Address - City:ROCKAWAY PARK
Practice Address - State:NY
Practice Address - Zip Code:11694-1826
Practice Address - Country:US
Practice Address - Phone:718-634-0364
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-06
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015447-1225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation