Provider Demographics
NPI:1992958730
Name:TEIG, LISA J (MS OTR/L)
Entity type:Individual
Prefix:MISS
First Name:LISA
Middle Name:J
Last Name:TEIG
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 E 57TH ST
Mailing Address - Street 2:APT 2G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2104
Mailing Address - Country:US
Mailing Address - Phone:516-457-1567
Mailing Address - Fax:
Practice Address - Street 1:157 E 57TH ST
Practice Address - Street 2:APT 2G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2104
Practice Address - Country:US
Practice Address - Phone:516-457-1567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-24
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14574-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist