Provider Demographics
NPI:1891272902
Name:MCQUAY, JEFFREY (OTR/L)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:MCQUAY
Suffix:
Gender:M
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 1:73 LINCOLN MILLS RD
Mailing Address - Street 2:
Mailing Address - City:EAST ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14445-1068
Mailing Address - Country:US
Mailing Address - Phone:585-746-4027
Mailing Address - Fax:585-407-1267
Practice Address - Street 1:73 LINCOLN MILLS RD
Practice Address - Street 2:
Practice Address - City:EAST ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14445-1068
Practice Address - Country:US
Practice Address - Phone:585-746-4027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-20
Last Update Date:2021-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021729225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06335533Medicaid