Healthcare Provider Details

I. General information

NPI: 1609833862
Provider Name (Legal Business Name): LORETTA ANN GARFUNKEL OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

179 STREET & LINDEN BLVD
ST. ALBANS NY
11425-0001
US

IV. Provider business mailing address

428 PINE ST
FREEPORT NY
11520-3115
US

V. Phone/Fax

Practice location:
  • Phone: 718-526-1000
  • Fax: 718-298-8531
Mailing address:
  • Phone: 516-546-0316
  • Fax: 718-298-8531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number003068
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: