Healthcare Provider Details

I. General information

NPI: 1841445186
Provider Name (Legal Business Name): LORI A. CILLINO MED. OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2008
Last Update Date: 12/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23 BENEFIT ST #23
WARWICK RI
02886-6700
US

IV. Provider business mailing address

23 BENEFIT ST #23
WARWICK RI
02886-6700
US

V. Phone/Fax

Practice location:
  • Phone: 401-739-5805
  • Fax:
Mailing address:
  • Phone: 401-739-5805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT00641
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: