Healthcare Provider Details

I. General information

NPI: 1235048463
Provider Name (Legal Business Name): JAMIE SHEIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

216 COUNTY ROUTE 64
MEXICO NY
13114-3229
US

IV. Provider business mailing address

20 BUCK DR
FREEHOLD NJ
07728-8001
US

V. Phone/Fax

Practice location:
  • Phone: 315-782-8821
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: