Provider Demographics
NPI:1235167396
Name:JENKINS, JANIS (AUD, CCC-A, FAAA)
Entity Type:Individual
Prefix:MRS
First Name:JANIS
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:AUD, CCC-A, FAAA
Other - Prefix:MRS
Other - First Name:JANIS
Other - Middle Name:Y
Other - Last Name:WATKIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD,CCC-A
Mailing Address - Street 1:158 ORLANDO DR
Mailing Address - Street 2:
Mailing Address - City:RARITAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08869-2124
Mailing Address - Country:US
Mailing Address - Phone:908-575-7800
Mailing Address - Fax:908-575-7619
Practice Address - Street 1:126 MAIN ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-5733
Practice Address - Country:US
Practice Address - Phone:609-520-0093
Practice Address - Fax:609-520-0562
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MG00077200231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ240056DPD9Medicare PIN