Provider Demographics
NPI:1104260918
Name:LANTZOUNIS, ALEXIA (OTR/L)
Entity type:Individual
Prefix:MS
First Name:ALEXIA
Middle Name:
Last Name:LANTZOUNIS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 7TH AVE
Mailing Address - Street 2:ROOM 819
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-5004
Mailing Address - Country:US
Mailing Address - Phone:212-356-3735
Mailing Address - Fax:
Practice Address - Street 1:120 EDGEMONT RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-2751
Practice Address - Country:US
Practice Address - Phone:914-912-1415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013734225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist