Provider Demographics
NPI:1366658296
Name:STERN, LORI ANN (OTR)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANN
Last Name:STERN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MISS
Other - First Name:LORI
Other - Middle Name:ANN
Other - Last Name:KAHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:9 CLUB HOUSE CT
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-1041
Mailing Address - Country:US
Mailing Address - Phone:631-941-9728
Mailing Address - Fax:
Practice Address - Street 1:9 CLUB HOUSE CT
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-1041
Practice Address - Country:US
Practice Address - Phone:631-941-9728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002865225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics