MEDICARE: PEGGY LEBENSFELD OCC THERAPIST

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	225X00000X	Occupational Therapist	3290	NY
2	225X00000X	Occupational Therapist	11977	FL

General Provider Information

NPI Number	:	1447260526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PEGGY LEBENSFELD OCC THERAPIST

Provider Business Mailing Address
First Line	:	550 SE MIZNER BLVD
Second Line	:	APT. 110B
City	:	BOCA RATON
State	:	FL
Zip	:	33432
Country	:	US
Telephone Number	:	560-251-4622
Fax Number	:	888-552-6176

Provider Business Practice Location Address
First Line	:	6169 S JOG RD
Second Line	:	STE A11
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-6579
Country	:	US
Telephone Number	:	561-432-0111
Fax Number	:	561-432-1075

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

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	04/13/2016

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