Individual
JESSICA PAUCIULLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
545 17TH ST, WEST BABYLON, NY 11704-2627
(631) 226-6273
Mailing address
545 17TH ST, WEST BABYLON, NY 11704-2627
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
12/22/2011
Last updated
09/19/2018
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