Provider Demographics
NPI:1144030313
Name:LEFEBVRE-FIELD, KERI
Entity type:Individual
Prefix:MRS
First Name:KERI
Middle Name:
Last Name:LEFEBVRE-FIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 COLUMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:NY
Mailing Address - Zip Code:12188-2121
Mailing Address - Country:US
Mailing Address - Phone:518-421-0772
Mailing Address - Fax:
Practice Address - Street 1:96 MENANDS RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12204-1400
Practice Address - Country:US
Practice Address - Phone:518-462-1811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008012-01225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist