Provider Demographics
NPI:1083053714
Name:DINEEN, JENNIFER
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:DINEEN
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 1:4 MANOR GROVE,
Mailing Address - Street 2:BLACKWATER
Mailing Address - City:CLARE
Mailing Address - State:0
Mailing Address - Zip Code:0
Mailing Address - Country:IE
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ST. VINCENTS UNIVERSITY HOSPITAL
Practice Address - Street 2:DEPARTMENT OF NEUROLOGY
Practice Address - City:DUBLIN
Practice Address - State:0
Practice Address - Zip Code:4
Practice Address - Country:IE
Practice Address - Phone:086-837-9119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-16
Last Update Date:2013-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA255061204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM