Provider Demographics
NPI:1316285745
Name:PASKOFF, LISA ANN (COTA)
Entity type:Individual
Prefix:MISS
First Name:LISA
Middle Name:ANN
Last Name:PASKOFF
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 E BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:SAUGERTIES
Mailing Address - State:NY
Mailing Address - Zip Code:12477-1911
Mailing Address - Country:US
Mailing Address - Phone:845-246-1424
Mailing Address - Fax:
Practice Address - Street 1:48 E BRIDGE ST
Practice Address - Street 2:
Practice Address - City:SAUGERTIES
Practice Address - State:NY
Practice Address - Zip Code:12477-1911
Practice Address - Country:US
Practice Address - Phone:845-246-1424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003046224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant