Healthcare Provider Details

I. General information

NPI: 1215878004
Provider Name (Legal Business Name): JESSICA BLAKE SCHEIBEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 CLEARWATER DR
PLAINVIEW NY
11803-6326
US

IV. Provider business mailing address

30 CLEARWATER DR
PLAINVIEW NY
11803-6326
US

V. Phone/Fax

Practice location:
  • Phone: 516-305-1398
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number029469
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: