Samantha Lulo, OTR/L, MS

Individual provider Active NPI Pediatric Occupational Therapist · Thiells, NY

NPI 1962005454 · NPPES record last updated Nov 18, 2020

Key facts

NPI
1962005454
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Occupational Therapist 225XP0200X
License
025176-01 (NY)
Practice address
7 Jacobs Rd
Thiells, NY 10984-1624
Phone
(845) 537-7017
NPI assigned
Nov 18, 2020
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Occupational Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Homeside Rehab PT OT SLP LLC (45 clinicians)

Practice addresses (Care Compare)

441 Route 306
Suite 2
Monsey, NY 10952-1234
Phone (718) 377-5000

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20241002002242 NY Practitioner - Occupational Therapist in Private Practice 3072044940 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
025176-01NYMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Homeside Rehab, PT, OT, SLP LLC Current
since Sep 20, 2024
Accepting new patients

Locations

441 Route 306
Ste 2
Monsey, NY 10952
Phone (201) 952-4436

296 Route 59
Ste 1225
Suffern, NY 10901

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 025176-01 NY Yes

Addresses

Primary practice location

7 Jacobs Rd
Thiells, NY 10984-1624

Mailing address

7 Jacobs Rd
Thiells, NY 10984-1624
Phone (845) 537-7017

Other providers in Thiells, NY

All providers in Thiells, NY · Pediatric Occupational Therapist in New York

Sources for this page

Verify at the official NPI Registry.