Provider Demographics
NPI:1770293045
Name:PLOW, JUSTIN JAMES (COTA)
Entity type:Individual
Prefix:MR
First Name:JUSTIN
Middle Name:JAMES
Last Name:PLOW
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2766 RIDGEWAY AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14626-4211
Mailing Address - Country:US
Mailing Address - Phone:585-857-3987
Mailing Address - Fax:
Practice Address - Street 1:20 ALLENS CREEK RD STE 1
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-3253
Practice Address - Country:US
Practice Address - Phone:585-461-6225
Practice Address - Fax:585-461-6228
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY484308224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant