Provider Demographics
NPI:1154766277
Name:BRIGGS, LORRAINE E (PT)
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:E
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 PEACHTREE CT
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-4616
Mailing Address - Country:US
Mailing Address - Phone:631-467-3700
Mailing Address - Fax:631-467-0928
Practice Address - Street 1:467 DELAWARE AVE
Practice Address - Street 2:SUITE 130B
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-3021
Practice Address - Country:US
Practice Address - Phone:518-641-0958
Practice Address - Fax:518-641-0958
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002824-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist