Provider Demographics
NPI:1548490477
Name:LOHMAN, STACY ANN (MS OTR/L)
Entity type:Individual
Prefix:
First Name:STACY
Middle Name:ANN
Last Name:LOHMAN
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 MANORVIEW WAY
Mailing Address - Street 2:
Mailing Address - City:MANORVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11949-2975
Mailing Address - Country:US
Mailing Address - Phone:631-325-2079
Mailing Address - Fax:
Practice Address - Street 1:58 MANORVIEW WAY
Practice Address - Street 2:
Practice Address - City:MANORVILLE
Practice Address - State:NY
Practice Address - Zip Code:11949-2975
Practice Address - Country:US
Practice Address - Phone:631-325-2079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-27
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010150225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist