Basic Information
| Provider Information | |||||||||
| NPI: | 1487806980 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LUPINSKI | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | N | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | O.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 162 EAST BROADWAY | ||||||||
| Address2: | |||||||||
| City: | MONTICELLO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 12701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8457961350 | ||||||||
| FaxNumber: | 8467963213 | ||||||||
| Practice Location | |||||||||
| Address1: | 162 EAST BROADWAY | ||||||||
| Address2: | |||||||||
| City: | MONTICELLO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 12701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8457961350 | ||||||||
| FaxNumber: | 8467963213 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/15/2008 | ||||||||
| LastUpdateDate: | 10/15/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 224Z00000X | 002238-1 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant |
No ID Information.