Provider Demographics
NPI:1033820527
Name:HAMDAN, JENNA
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:HAMDAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92-27 160TH ST
Mailing Address - Street 2:APT 616
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11433
Mailing Address - Country:US
Mailing Address - Phone:734-205-8417
Mailing Address - Fax:
Practice Address - Street 1:1041 THIRD AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:11065
Practice Address - Country:US
Practice Address - Phone:212-319-3977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant