Basic Information
Provider Information
NPI: 1295243194
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LAPKIN
FirstName: STEVEN
MiddleName: BRADFORD
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5830 NW 25TH TER
Address2:  
City: BOCA RATON
State: FL
PostalCode: 334962226
CountryCode: US
TelephoneNumber: 5619978039
FaxNumber: 5619978039
Practice Location
Address1: 5830 NW 25TH TER
Address2:  
City: BOCA RATON
State: FL
PostalCode: 334962226
CountryCode: US
TelephoneNumber: 5619978039
FaxNumber: 5619978039
Other Information
ProviderEnumerationDate: 01/14/2018
LastUpdateDate: 01/14/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
224Z00000X15917FLY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant 

No ID Information.


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