Provider Demographics
NPI:1558591560
Name:TELAROLE, JANA R (OTR/L)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:R
Last Name:TELAROLE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:JANA
Other - Middle Name:R
Other - Last Name:RIGBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 82
Mailing Address - Street 2:
Mailing Address - City:CHADWICKS
Mailing Address - State:NY
Mailing Address - Zip Code:13319-0082
Mailing Address - Country:US
Mailing Address - Phone:315-737-6403
Mailing Address - Fax:
Practice Address - Street 1:3310 ONEIDA ST
Practice Address - Street 2:
Practice Address - City:CHADWICKS
Practice Address - State:NY
Practice Address - Zip Code:13319
Practice Address - Country:US
Practice Address - Phone:315-737-6403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-24
Last Update Date:2009-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6640576225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist