Provider Demographics
NPI:1164862355
Name:GENERALLA, JENILEE APRIL MARY (MD)
Entity Type:Individual
Prefix:MISS
First Name:JENILEE
Middle Name:APRIL MARY
Last Name:GENERALLA
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:500 UNIVERSITY DRIVE
Mailing Address - Street 2:DEPARTMENT OF PSYCHIATRY, H073, C5600
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-0850
Mailing Address - Country:US
Mailing Address - Phone:717-531-0003
Mailing Address - Fax:717-531-6491
Practice Address - Street 1:500 UNIVERSITY DRIVE
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY, H073, C5600
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-0850
Practice Address - Country:US
Practice Address - Phone:717-531-0003
Practice Address - Fax:717-531-6491
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program