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General NPI Number Information
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NPI Number | 1265788954
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Entity Type | Organization
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Legal Business Name | LFM OT PC
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Dates
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Enumeration Date | 07/31/2012
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Last Update Date | 10/30/2013
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Provider Practice Location Address
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Address Line | 220 CENTENNIAL AVE
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City | PISCATAWAY
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State | NJ
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Zip | 08854-3940
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Country | US
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Telephone | 718-503-4062
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Fax |
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Provider Business Mailing Address
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Address Line | 200 BETHEL LOOP APT 2E
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City | BROOKLYN
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State | NY
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Zip | 11239-1702
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OT
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Name | MAX ZANDBERG
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Credential |
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Telephone | 718-503-4062
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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 | 016726N
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License Number State | NY
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