Basic Information
| Provider Information | |||||||||
| NPI: | 1003292996 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCANNELL | ||||||||
| FirstName: | LINDSEY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
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| OtherLastName: | SCANNELL | ||||||||
| OtherFirstName: | LINDSEY | ||||||||
| OtherMiddleName: | BROOKE | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 42 STATE PL | ||||||||
| Address2: | |||||||||
| City: | HUNTINGTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117435633 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 42 STATE PL | ||||||||
| Address2: | |||||||||
| City: | HUNTINGTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117435633 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6314700909 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2015 | ||||||||
| LastUpdateDate: | 08/03/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 222Q00000X | 592922121 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Developmental Therapist | 222Q00000X | 383710101 | NY | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Developmental Therapist | 222Q00000X | 384049101 | NY | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Developmental Therapist |
No ID Information.