Provider Demographics
NPI:1194978056
Name:ROPIAK, JILL MARIE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:MARIE
Last Name:ROPIAK
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 1:2 BLACK SWAN CT
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-3977
Mailing Address - Country:US
Mailing Address - Phone:203-775-0131
Mailing Address - Fax:
Practice Address - Street 1:2 BLACK SWAN CT
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-3977
Practice Address - Country:US
Practice Address - Phone:203-775-0131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079221225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics