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General NPI Number Information
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NPI Number | 1578973475
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Entity Type | Individual
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Provider Name | LAUREN CATHERINE VAUGHAN OTR/L
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Gender | Female
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Dates
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Enumeration Date | 04/30/2014
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 161 CANTERBURY RD
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City | WILLISTON PARK
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State | NY
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Zip | 11596
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Country | US
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Telephone | 516-567-2935
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Fax |
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Provider Business Mailing Address
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Address Line | 161 CANTERBURY RD
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City | WILLISTON PARK
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State | NY
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Zip | 11596-2212
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Country | US
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Telephone | 516-567-2935
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 018771
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License Number State | NY
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