Mrs Lisa Irene Petersen, OTR/L is a
Occupational Therapist - Pediatrics based in Waterford, New York. Mrs Lisa Irene Petersen is licensed to practice in New York (license number 02203-1) and her current practice location is
125 Middletown Rd, Waterford, New York. She can be reached at her office (for appointments etc.) via phone at
(518) 237-0800.
NPI number for Mrs Lisa Irene Petersen is 1831734961 and her current mailing address is 125 Middletown Rd, Waterford, New York. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1831734961.
Healthcare Provider's Profile
Full Name | Mrs Lisa Irene Petersen |
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Gender | Female |
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Speciality | Occupational Therapist - Pediatrics |
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Location | 125 Middletown Rd, Waterford, New York |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1831734961
- Provider Enumeration Date: 11/13/2019
- Last Update Date: 11/13/2019
Medical Identifiers
Medical identifiers for Mrs Lisa Irene Petersen such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1831734961 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225XP0200X | Occupational Therapist - Pediatrics | 02203-1 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Lisa Irene Petersen is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Lisa Irene Petersen, OTR/L 125 Middletown Rd, Waterford, NY 12188-1516 Ph: (518) 237-0800 | Mrs Lisa Irene Petersen, OTR/L 125 Middletown Rd, Waterford, NY 12188-1516 Ph: (518) 237-0800 |
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