Provider Demographics
NPI:1154613883
Name:TROTMAN, JACQUELINE ELIZABETH (OTR/L)
Entity type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:ELIZABETH
Last Name:TROTMAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11938 225TH ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIA HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11411-2116
Mailing Address - Country:US
Mailing Address - Phone:718-276-4466
Mailing Address - Fax:717-276-4466
Practice Address - Street 1:11938 225TH ST
Practice Address - Street 2:
Practice Address - City:CAMBRIA HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11411-2116
Practice Address - Country:US
Practice Address - Phone:718-276-4466
Practice Address - Fax:718-276-4466
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-13
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0099551225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation