Provider Demographics
NPI:1265825251
Name:SHEEHAN, JILL PATRICIA (OTR/L)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:PATRICIA
Last Name:SHEEHAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 GREENWICH ST APT A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-2703
Mailing Address - Country:US
Mailing Address - Phone:646-379-0532
Mailing Address - Fax:
Practice Address - Street 1:322 GREENWICH ST APT A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-2703
Practice Address - Country:US
Practice Address - Phone:646-379-0532
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-15
Last Update Date:2015-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019531225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist