MEDICARE: MS. LEILA JANINE LUCERO OT

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	225X00000X	Occupational Therapist	008684-1	NY

General Provider Information

NPI Number	:	1275788846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LEILA JANINE LUCERO OT

Provider Business Mailing Address
First Line	:	850 HUNGERFORD DR
Second Line	:
City	:	ROCKVILLE
State	:	MD
Zip	:	20850-1718
Country	:	US
Telephone Number	:	240-740-5500
Fax Number	:

Provider Business Practice Location Address
First Line	:	8001 LYNBROOK DR
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20814-4642
Country	:	US
Telephone Number	:	240-740-5500
Fax Number	:

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

Provider Enumeration Date	:	11/24/2008
Last Update Date	:	09/16/2021

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