Provider Demographics
NPI:1770859977
Name:CAMIGUEL, JAIMEE GAYLE (OTR/L)
Entity Type:Individual
Prefix:
First Name:JAIMEE
Middle Name:GAYLE
Last Name:CAMIGUEL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 W 94TH ST RM 412
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6922
Mailing Address - Country:US
Mailing Address - Phone:646-338-8564
Mailing Address - Fax:
Practice Address - Street 1:163 W 97TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6453
Practice Address - Country:US
Practice Address - Phone:212-678-2854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-02
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013976-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist