Provider Demographics
NPI:1225195795
Name:HASTINGS, JENNIFER MARIA (MA, MT-BC, NMT)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:MARIA
Last Name:HASTINGS
Suffix:
Gender:F
Credentials:MA, MT-BC, NMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 RIVERSIDE BLVD APT 7S
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10069-0309
Mailing Address - Country:US
Mailing Address - Phone:917-705-0906
Mailing Address - Fax:
Practice Address - Street 1:80 RIVERSIDE BLVD
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10069-0301
Practice Address - Country:US
Practice Address - Phone:917-342-7599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225A00000X
NY000593221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist