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Organization
WL OCCUPATIONAL THERAPY SERVICES PC
Active
Organization
WL OCCUPATIONAL THERAPY SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILMER A LACSON OT (PRESIDENT)
(917) 484-1465
Entity
Organization
Contact information
Practice address
2752 OCEAN AVE, BROOKLYN, NY 11229-4706
(718) 484-8765
Mailing address
315 E 108TH ST, APT 2C, NEW YORK, NY 10029-4245
(917) 484-1465
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015773
LICENSE
NY
Enumeration date
12/29/2016
Last updated
12/29/2016
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