Provider Demographics
NPI:1154542975
Name:LETTERIO, LORI BETH (OTR)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:BETH
Last Name:LETTERIO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1198 OCEAN AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:SEA BRIGHT
Mailing Address - State:NJ
Mailing Address - Zip Code:07760
Mailing Address - Country:US
Mailing Address - Phone:304-282-1618
Mailing Address - Fax:
Practice Address - Street 1:ONE ROOSEVELT DRIVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837
Practice Address - Country:US
Practice Address - Phone:732-321-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00398700225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist