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General NPI Number Information
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NPI Number | 1336388263
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Entity Type | Individual
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Provider Name | LISA B FREIDA O.T.
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Gender | Female
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Dates
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Enumeration Date | 02/17/2009
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Last Update Date | 01/09/2012
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Provider Practice Location Address
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Address Line | 1548 SCHLEGEL RD
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City | WEBSTER
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State | NY
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Zip | 14580-8506
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Country | US
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Telephone | 585-732-3988
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Fax | 585-216-6004
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Provider Business Mailing Address
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Address Line | 1548 SCHLEGEL RD
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City | WEBSTER
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State | NY
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Zip | 14580-8506
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Country | US
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Telephone | 585-732-3988
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Fax | 585-216-6004
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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 | 007562-1
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License Number State | NY
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