Basic Information
| Provider Information | |||||||||
| NPI: | 1629554258 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | CALI | ||||||||
| FirstName: | LEA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30-62 38TH STREET | ||||||||
| Address2: | APT 1B | ||||||||
| City: | ASTORIA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5514270083 | ||||||||
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| Practice Location | |||||||||
| Address1: | 51-55 N ROUTE 9W | ||||||||
| Address2: | |||||||||
| City: | WEST HAVERSTRAW | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109931195 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8457864000 | ||||||||
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| ProviderEnumerationDate: | 07/17/2018 | ||||||||
| LastUpdateDate: | 07/17/2018 | ||||||||
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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 | 225X00000X | 018152-1 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.