Basic Information
| Provider Information | |||||||||
| NPI: | 1811361348 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PLUMLEE | ||||||||
| FirstName: | JILLIAN | ||||||||
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| Credential: | M.S., OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 310 NORTH AVE | ||||||||
| Address2: | |||||||||
| City: | PENN YAN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 145271019 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6072152556 | ||||||||
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| Practice Location | |||||||||
| Address1: | 220 STEUBEN ST | ||||||||
| Address2: | |||||||||
| City: | MONTOUR FALLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 148659740 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6075357121 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2015 | ||||||||
| LastUpdateDate: | 07/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/28/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 019902-1 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.