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NPI Code Detail

MEDICARE: AMY LOWELL MS OTRL

MEDICARE: AMY LOWELL MS OTRL
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
1225XP0200XPediatric Occupational Therapist09243MA

General Provider Information

NPI Number : 1619017100
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY LOWELL MS OTRL
Provider Business Mailing Address
First Line : 15 MULLER AVE
Second Line :
City : CAMBRIDGE
State : MA
Zip : 02140-1008
Country : US
Telephone Number : 617-645-3347
Fax Number :
Provider Business Practice Location Address
First Line : 124 WATERTOWN ST
Second Line :
City : WATERTOWN
State : MA
Zip : 02472-2576
Country : US
Telephone Number : 617-923-4410
Fax Number : 617-923-0468
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2007
Last Update Date : 07/08/2007

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Directions to “ AMY LOWELL MS OTRL” Practice Location

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