Provider Demographics
NPI:1568885689
Name:MCCABE, JESSICA LAUREN (OTR/L, MS)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:LAUREN
Last Name:MCCABE
Suffix:
Gender:F
Credentials:OTR/L, MS
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:LAUREN
Other - Last Name:ATTRIDGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L, MS
Mailing Address - Street 1:4 JAMAICA DR
Mailing Address - Street 2:
Mailing Address - City:SOUND BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11789-1331
Mailing Address - Country:US
Mailing Address - Phone:631-741-8636
Mailing Address - Fax:
Practice Address - Street 1:227 MADISON ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-7537
Practice Address - Country:US
Practice Address - Phone:212-441-5460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-24
Last Update Date:2015-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018493225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist