Provider Demographics
NPI:1164441630
Name:HASKINS, JENNIFER MARGARET (RPA-C)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:MARGARET
Last Name:HASKINS
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:KIEFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPA-C
Mailing Address - Street 1:435 EAST HENRIETTA RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-4629
Mailing Address - Country:US
Mailing Address - Phone:585-760-5466
Mailing Address - Fax:585-760-5467
Practice Address - Street 1:435 EAST HENRIETTA RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-4629
Practice Address - Country:US
Practice Address - Phone:585-760-5466
Practice Address - Fax:585-760-5467
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY9488363AM0700X
NY09488-1363AM0700X
PAMA051311363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP96193Medicare UPIN