Provider Demographics
NPI:1497849137
Name:CASOLINI DAL BO, JENIFFER M (OTR)
Entity Type:Individual
Prefix:MRS
First Name:JENIFFER
Middle Name:M
Last Name:CASOLINI DAL BO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3457 E.CHURCH STREET
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:NY
Mailing Address - Zip Code:14057
Mailing Address - Country:US
Mailing Address - Phone:716-992-2208
Mailing Address - Fax:
Practice Address - Street 1:700 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203
Practice Address - Country:US
Practice Address - Phone:716-854-5700
Practice Address - Fax:716-854-5800
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0122161225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand