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General NPI Number Information
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NPI Number | 1205639069
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Entity Type | Organization
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Legal Business Name | JESSICA SEELY, LLC
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Dates
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Enumeration Date | 03/28/2025
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 10 CAMELOT LN
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City | EAST SETAUKET
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State | NY
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Zip | 11733-1707
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Country | US
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Telephone | 631-371-3178
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Fax | 707-361-4615
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Provider Business Mailing Address
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Address Line | 1239 N COUNTRY RD STE 4
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City | STONY BROOK
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State | NY
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Zip | 11790-1920
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Country | US
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Telephone | 631-371-3178
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JESSICA LYNN LOPEZ SEELY
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Credential | OTD, OTR/L
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Telephone | 631-371-3178
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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