Healthcare Provider Details

I. General information

NPI: 1215855978
Provider Name (Legal Business Name): LORENA CHAN OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 SKYLINE DR
HAWTHORNE NY
10532-2152
US

IV. Provider business mailing address

231 BUTTONWOOD AVE
CORTLANDT MNR NY
10567-4911
US

V. Phone/Fax

Practice location:
  • Phone: 914-347-5990
  • Fax:
Mailing address:
  • Phone: 646-413-0948
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number031220-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: