Provider Demographics
NPI:1063138295
Name:KAPLAN, JENNIFER (MS OTR/L)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:KAPLAN
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:JENNFIER
Other - Middle Name:
Other - Last Name:MESSINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS OTR/L
Mailing Address - Street 1:94 CONNETQUOT RD
Mailing Address - Street 2:
Mailing Address - City:BAYPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11705-2112
Mailing Address - Country:US
Mailing Address - Phone:518-745-9472
Mailing Address - Fax:
Practice Address - Street 1:1038 W JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-3208
Practice Address - Country:US
Practice Address - Phone:631-368-2583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027226225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist