MEDICARE: LINDSAY JEAN ORCUTT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225500000X	Respiratory/Developmental/Rehabilitative Specialist/Technologist	451615	NY
2	225CX0006X	Orientation and Mobility Training Rehabilitation Counselor	5737

General Provider Information

NPI Number	:	1164705190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSAY JEAN ORCUTT

Provider Business Mailing Address
First Line	:	184 19TH ST # 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11232-1027
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	184 19TH ST # 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11232-1027
Country	:	US
Telephone Number	:	917-334-0416
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2011
Last Update Date	:	09/26/2011

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