Active NPI
Lisa Marie Lichak
- Pediatric Occupational Therapist
- Geneva, NY
National Provider Identifier
1255587887
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- 005890-1
- Practice address
- 731 Pre Emption Rd
Geneva, NY 14456-1335 - Phone
- (315) 789-6828
- NPI assigned
- Aug 14, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 005890-1 | NY | Primary |
Addresses
Primary practice location
731 Pre Emption Rd
Geneva, NY 14456-1335
Mailing address
731 Pre Emption Rd
Geneva, NY 14456-1335
Phone (315) 789-6828
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005890-1 | NY | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218672000000",
"number": "1255587887",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "731 PRE EMPTION RD",
"city": "GENEVA",
"state": "NY",
"postal_code": "144561335",
"telephone_number": "315-789-6828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "731 PRE EMPTION RD",
"city": "GENEVA",
"state": "NY",
"postal_code": "144561335",
"telephone_number": "315-789-6828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LICHAK",
"first_name": "LISA",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-14",
"last_updated": "2008-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "NY",
"license": "005890-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Geneva, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.