Basic Information
Provider Information
NPI: 1063717296
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CHABAI-LINDSAY
FirstName: MARIA
MiddleName: ELIZABETH
NamePrefix:  
NameSuffix:  
Credential: OTR
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: CHABAI
OtherFirstName: MARIA
OtherMiddleName: ELIZABETH
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: OTR
OtherLastNameType: 1
Mailing Information
Address1: 2222 SULLIVAN TRL
Address2:  
City: EASTON
State: PA
PostalCode: 180407958
CountryCode: US
TelephoneNumber: 8009449782
FaxNumber: 6104382046
Practice Location
Address1: 3140 EL CAMINO REAL
Address2:  
City: CARLSBAD
State: CA
PostalCode: 920082108
CountryCode: US
TelephoneNumber: 7607209898
FaxNumber: 7607201636
Other Information
ProviderEnumerationDate: 01/19/2011
LastUpdateDate: 01/19/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000XOT2765CAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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