Provider Demographics
NPI:1780068965
Name:FRANKLIN, LORI (OCCUPATIONAL THERAPI)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:FRANKLIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:176 VREELAND AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1623
Mailing Address - Country:US
Mailing Address - Phone:201-421-0829
Mailing Address - Fax:
Practice Address - Street 1:176 VREELAND AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07432-1623
Practice Address - Country:US
Practice Address - Phone:201-421-0829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-17
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00199300174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ46TR00199300OtherLICENSE