Healthcare Provider Details

I. General information

NPI: 1851267694
Provider Name (Legal Business Name): JILLIAN SALVATRICE ARICOLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2025
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 FOREST AVE
STATEN ISLAND NY
10301-2638
US

IV. Provider business mailing address

1204 PLYMOUTH DR
BRICK NJ
08724-1027
US

V. Phone/Fax

Practice location:
  • Phone: 718-979-5678
  • Fax:
Mailing address:
  • Phone: 908-692-5946
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: