Luanne Horne

Individual provider Active NPI Occupational Therapist · Brightwaters, NY

NPI 1972874642 · NPPES record last updated Jan 26, 2012

Key facts

NPI
1972874642
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
L-63012149 (NY)
Practice address
474 Richland Blvd
Brightwaters, NY 11718-1224
Phone
(631) 968-8532
NPI assigned
Jan 26, 2012
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 participation

Medicare fee-for-service enrollment
Enrolled in NY

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20120307000711 NY Practitioner - Occupational Therapist in Private Practice 3375702566 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
012149NYMDClinical Psychologist
L-63012149NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Welllife Network Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X L-63012149 NY Yes

Addresses

Primary practice location

474 Richland Blvd
Brightwaters, NY 11718-1224

Mailing address

474 Richland Blvd
Brightwaters, NY 11718-1224
Phone (631) 968-8532

Other providers in Brightwaters, NY

All providers in Brightwaters, NY · Occupational Therapist in New York

Sources for this page

Verify at the official NPI Registry.