Healthcare Provider Details

I. General information

NPI: 1235545492
Provider Name (Legal Business Name): LAUREN JAKLITSCH M.S., OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN MICHELLE JAKLITSCH M.S.

II. Dates (important events)

Enumeration Date: 07/09/2014
Last Update Date: 10/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 I U WILLETS RD
ALBERTSON NY
11507-1516
US

IV. Provider business mailing address

300 CORPORATE BLVD S
YONKERS NY
10701-6862
US

V. Phone/Fax

Practice location:
  • Phone: 516-465-1666
  • Fax: 516-465-3786
Mailing address:
  • Phone: 914-294-6300
  • Fax: 914-294-6183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: