Healthcare Provider Details

I. General information

NPI: 1619889177
Provider Name (Legal Business Name): LUCAS MICHAEL TOTORO OTD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BROADVIEW AVE
PURCHASE NY
10577-1916
US

IV. Provider business mailing address

91 PRIMROSE ST
KATONAH NY
10536-3105
US

V. Phone/Fax

Practice location:
  • Phone: 914-825-4466
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberP145823
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: