National Provider Identifier
Jill Kristen Mumbach, OT
Jill Kristen Mumbach, OT is listed in the NPPES registry with a primary specialty of Pediatric Occupational Therapist in East Concord, NY and a listed phone number of (716) 592-9829.
Profile Overview
- NPI
- 1629359310
- Provider Type
- Individual
- Primary Specialty
- Pediatric Occupational Therapist
- Enumeration Date
- September 08, 2011
- Last Updated
- September 08, 2011
Practice Location
- 12970 Van Slyke RD
- East Concord, NY 14055-9796
Phone: (716) 592-9829
Specialties
- Pediatric Occupational Therapist (225XP0200X)
Full Record
- NPI
- 1629359310
- Entity Type
- Individual
- Last Name
- Mumbach
- First Name
- Jill
- Middle Name
- Kristen
- Credential
- OT
- Provider Other Last Name
- Mumbach
- Provider Other First Name
- Jill
- Provider Other Middle Name
- Kristen
- Provider Other Credential Text
- OT
- Provider Other Last Name Type Code
- 5
- Mailing Street Address
- 12970 Van Slyke RD
- Mailing City
- East Concord
- Mailing State
- NY
- Mailing ZIP Code
- 14055-9796
- Mailing Country
- US
- Mailing Phone
- (716) 592-9829
- Practice Street Address
- 12970 Van Slyke RD
- Practice City
- East Concord
- Practice State
- NY
- Practice ZIP Code
- 14055-9796
- Practice Country
- US
- Practice Phone
- (716) 592-9829
- Enumeration Date
- September 08, 2011
- Last Updated
- September 08, 2011
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Pediatric Occupational Therapist (225XP0200X)