MEDICARE: STEFANIE WARNER LUKINS M.S., OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist	46TR00527900	NJ

General Provider Information

NPI Number	:	1164860607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEFANIE WARNER LUKINS M.S., OTR/L

Provider Business Mailing Address
First Line	:	457 MADISON AVE
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-6724
Country	:	US
Telephone Number	:	732-267-6075
Fax Number	:

Provider Business Practice Location Address
First Line	:	3349 HIGHWAY 138 EAST, BUILDING B SUITE A
Second Line	:	ABILITIES IN ACTION
City	:	WALL TOWNSHIP
State	:	NJ
Zip	:	08724
Country	:	US
Telephone Number	:	732-280-6050
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2013
Last Update Date	:	06/14/2013

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