Provider Demographics
NPI:1316362122
Name:AMBROSKY, JAMILYN MARIE (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:JAMILYN
Middle Name:MARIE
Last Name:AMBROSKY
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 PRICE AVE
Mailing Address - Street 2:APT I-23
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-1843
Mailing Address - Country:US
Mailing Address - Phone:267-636-3205
Mailing Address - Fax:
Practice Address - Street 1:214 PRICE AVE
Practice Address - Street 2:APT I-23
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-1843
Practice Address - Country:US
Practice Address - Phone:267-636-3205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-03
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00502900225X00000X
DEU10001364225X00000X
CAOT13945225X00000X
PAOC011147225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist