Provider Demographics
NPI:1730626342
Name:LEFKOWITZ, STACEY (OT)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:
Last Name:LEFKOWITZ
Suffix:
Gender:
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8343 118TH ST
Mailing Address - Street 2:APT 5M
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-2371
Mailing Address - Country:US
Mailing Address - Phone:516-317-5486
Mailing Address - Fax:
Practice Address - Street 1:8343 118TH ST
Practice Address - Street 2:APT 5M
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-2371
Practice Address - Country:US
Practice Address - Phone:516-317-5486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-21
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029969225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist