Provider Demographics
NPI:1033855523
Name:TOLENTINO, JINGLE ANTONELLA
Entity Type:Individual
Prefix:
First Name:JINGLE
Middle Name:ANTONELLA
Last Name:TOLENTINO
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 1:5101 39TH AVE APT MM23
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11104-1142
Mailing Address - Country:US
Mailing Address - Phone:929-928-2224
Mailing Address - Fax:
Practice Address - Street 1:5101 39TH AVE APT MM23
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11104-1142
Practice Address - Country:US
Practice Address - Phone:929-928-2224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator