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NPI Code Detail

MEDICARE: JACQUELYN MARIE LAZZARO OTD, OTR/L

MEDICARE: JACQUELYN MARIE LAZZARO OTD, OTR/L
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
1225X00000XOccupational Therapist026291NY

General Provider Information

NPI Number : 1225553795
Entity Type Code : Individual
Provider Name (Legal Business Name) : JACQUELYN MARIE LAZZARO OTD, OTR/L
Provider Business Mailing Address
First Line : 25 HEARTHSTONE LN
Second Line :
City : ROCHESTER
State : NY
Zip : 14617-2012
Country : US
Telephone Number : 516-680-8503
Fax Number :
Provider Business Practice Location Address
First Line : 1555 LONG POND RD
Second Line :
City : ROCHESTER
State : NY
Zip : 14626-4164
Country : US
Telephone Number : 585-723-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2017
Last Update Date : 01/14/2026

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