Basic Information
Provider Information
NPI: 1912178658
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GALLUZZI
FirstName: LINDSEY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: OT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 2002
Address2:  
City: EAST SYRACUSE
State: NY
PostalCode: 130574502
CountryCode: US
TelephoneNumber: 3154492208
FaxNumber: 3154452936
Practice Location
Address1: 1603 COURT ST
Address2:  
City: SYRACUSE
State: NY
PostalCode: 132081834
CountryCode: US
TelephoneNumber: 3154557591
FaxNumber: 3154552446
Other Information
ProviderEnumerationDate: 03/21/2008
LastUpdateDate: 03/21/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X015036NYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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