Healthcare Provider Details

I. General information

NPI: 1841835675
Provider Name (Legal Business Name): JESSICA LYNN MCLAUGHLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2019
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 RIVERSIDE DR
BINGHAMTON NY
13905-4246
US

IV. Provider business mailing address

33 LEWIS RD STE 2
BINGHAMTON NY
13905-1040
US

V. Phone/Fax

Practice location:
  • Phone: 607-798-5111
  • Fax:
Mailing address:
  • Phone: 607-763-6033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number022588-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: