Provider Demographics
NPI:1669129870
Name:DIGIACINTO, JILLIAN TAYLOR (OTR/L)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:TAYLOR
Last Name:DIGIACINTO
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 1:337 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:HASBROUCK HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07604-1609
Mailing Address - Country:US
Mailing Address - Phone:201-663-5233
Mailing Address - Fax:
Practice Address - Street 1:794 FRANKLIN AVE STE 204
Practice Address - Street 2:
Practice Address - City:FRANKLIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07417-1399
Practice Address - Country:US
Practice Address - Phone:201-891-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-08
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR01044700225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist