Lisa V Stewart, OTR

Individual provider Active NPI Early Intervention Provider Agency · Marcy, NY

NPI 1295962009 · NPPES record last updated Jun 18, 2009

Key facts

NPI
1295962009
Entity type
Individual (NPI type 1)
Primary specialty
Early Intervention Provider Agency 252Y00000X
License
002969-1 (NY)
Practice address
9217 Michaels LN
Marcy, NY 13403-3226
Phone
(315) 865-6062
NPI assigned
Jun 18, 2009
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
002969-1NYMDEarly Intervention Provider Agency

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X 002969-1 NY Yes

Addresses

Primary practice location

9217 Michaels LN
Marcy, NY 13403-3226

Mailing address

9217 Michaels LN
Marcy, NY 13403-3226
Phone (315) 865-6062

Other providers in Marcy, NY

All providers in Marcy, NY · Early Intervention Provider Agency in New York

Sources for this page

Verify at the official NPI Registry.