Provider Demographics
NPI:1063556397
Name:LENNON, NORMA BETH (OCCUPATIONAL THERAPI)
Entity type:Individual
Prefix:
First Name:NORMA
Middle Name:BETH
Last Name:LENNON
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 MARTHA LN
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-3818
Mailing Address - Country:US
Mailing Address - Phone:631-656-5503
Mailing Address - Fax:
Practice Address - Street 1:1770 MOTOR PKWY
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11749-5260
Practice Address - Country:US
Practice Address - Phone:631-582-0088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003087-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty