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General NPI Number Information
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NPI Number | 1154613883
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Entity Type | Individual
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Provider Name | JACQUELINE ELIZABETH TROTMAN OTR/L
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Gender | Female
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Dates
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Enumeration Date | 05/13/2011
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Last Update Date | 05/13/2011
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Provider Practice Location Address
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Address Line | 11938 225TH ST
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City | CAMBRIA HEIGHTS
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State | NY
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Zip | 11411-2116
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Country | US
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Telephone | 718-276-4466
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Fax | 718-276-4466
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Provider Business Mailing Address
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Address Line | 11938 225TH ST
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City | CAMBRIA HEIGHTS
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State | NY
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Zip | 11411-2116
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Country | US
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Telephone | 718-276-4466
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Fax | 717-276-4466
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | 0099551
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License Number State | NY
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