Organization
LIFELONG THERAPEUTICS OT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY WAYNE CIOLINO OTR/L (PRESIDENT)
(631) 278-0665
Entity
Organization
Contact information
Practice address
165 BEVERLY RD, HUNTINGTON STATION, NY 11746-4522
(631) 278-0665
(631) 549-1957
Mailing address
143 CHARDONNAY DR, EAST QUOGUE, NY 11942-3829
(631) 278-0665
(631) 549-1957
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
006369
NY
Other
Enumeration date
11/28/2011
Last updated
02/21/2012
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