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General NPI Number Information
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NPI Number | 1225553795
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Entity Type | Individual
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Provider Name | JACQUELYN MARIE LAZZARO OTD, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/07/2017
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 1555 LONG POND RD
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City | ROCHESTER
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State | NY
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Zip | 14626-4164
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Country | US
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Telephone | 585-723-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 25 HEARTHSTONE LN
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City | ROCHESTER
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State | NY
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Zip | 14617-2012
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Country | US
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Telephone | 516-680-8503
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 026291
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License Number State | NY
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