Individual provider · NPI-1
Jillian Bigelow, OTR/L
Early Intervention Provider Agency · Oswego, NY
NPI number1962887273
StatusActive
Last updated in NPPESOct 12, 2017
Details
- NPI
- 1962887273
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Jillian Bigelow
- Credential
- OTR/L
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 28, 2015
- Last updated
- Oct 12, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 252Y00000X | Early Intervention Provider Agency | p98497 | NY | Yes |
| 225X00000X | Occupational Therapist | 020119 | NY |
Practice location
159 W 1st StOswego, NY 13126-2045
Phone 315-342-9575
Mailing address
5151 Munro RdCamillus, NY 13031-8700
Phone 518-730-6186
Other practice locations
673 Columbia Tpke
East Greenbush, NY 12061-2130
East Greenbush, NY 12061-2130
Phone 518-473-7112
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