Provider Demographics
NPI:1346670510
Name:SHAPIRO, JILLIAN RIKKI (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:RIKKI
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 LITTLE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-4550
Mailing Address - Country:US
Mailing Address - Phone:631-266-4400
Mailing Address - Fax:
Practice Address - Street 1:25 LITTLE PLAINS RD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-4550
Practice Address - Country:US
Practice Address - Phone:631-266-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-25
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019844225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics