Provider Demographics
NPI:1306365663
Name:KRASINSKI, JILLIAN PATRICE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:PATRICE
Last Name:KRASINSKI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 OLIVE LN
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-2757
Mailing Address - Country:US
Mailing Address - Phone:716-783-5566
Mailing Address - Fax:
Practice Address - Street 1:3950 E ROBINSON RD STE 201
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2042
Practice Address - Country:US
Practice Address - Phone:716-636-3950
Practice Address - Fax:716-636-6282
Is Sole Proprietor?:No
Enumeration Date:2017-09-18
Last Update Date:2017-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042127-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist