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NPI Code Detail

MEDICARE: LISA GEORGE OTA/L

MEDICARE: LISA GEORGE OTA/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
1224Z00000XOccupational Therapy Assistant006957-1NY

General Provider Information

NPI Number : 1194970806
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA GEORGE OTA/L
Provider Business Mailing Address
First Line : 1028 E 179TH ST
Second Line :
City : BRONX
State : NY
Zip : 10460-2222
Country : US
Telephone Number : 718-842-0200
Fax Number :
Provider Business Practice Location Address
First Line : 1028 E 179TH ST
Second Line :
City : BRONX
State : NY
Zip : 10460-2222
Country : US
Telephone Number : 718-842-0200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2008
Last Update Date : 11/21/2008

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Directions to “ LISA GEORGE OTA/L” Practice Location

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