Provider Demographics
NPI:1548605355
Name:LAUEN, MELISSA (COTA)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:LAUEN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 N LIBERTY DR
Mailing Address - Street 2:
Mailing Address - City:TOMKINS COVE
Mailing Address - State:NY
Mailing Address - Zip Code:10986-1512
Mailing Address - Country:US
Mailing Address - Phone:914-924-5329
Mailing Address - Fax:
Practice Address - Street 1:254 S MAIN ST
Practice Address - Street 2:SUITE 400
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3340
Practice Address - Country:US
Practice Address - Phone:845-638-1592
Practice Address - Fax:845-638-2728
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005386-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant