MEDICARE: ALLISON ANNA LAZAROS OTR

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	028815-01	NY

General Provider Information

NPI Number	:	1841059383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON ANNA LAZAROS OTR

Provider Business Mailing Address
First Line	:	671 ROUTE 82
Second Line	:
City	:	HOPEWELL JUNCTION
State	:	NY
Zip	:	12533-5746
Country	:	US
Telephone Number	:	845-475-2039
Fax Number	:

Provider Business Practice Location Address
First Line	:	696 DUTCHESS TPKE STE C
Second Line	:
City	:	POUGHKEEPSIE
State	:	NY
Zip	:	12603-6445
Country	:	US
Telephone Number	:	845-202-0157
Fax Number	:

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

Provider Enumeration Date	:	03/18/2024
Last Update Date	:	03/18/2024

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