Provider Demographics
NPI:1326753948
Name:SHNAYERSON, JENNA
Entity Type:Individual
Prefix:MS
First Name:JENNA
Middle Name:
Last Name:SHNAYERSON
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 1:1801 MILTON AVE.
Mailing Address - Street 2:P.O.BOX 264
Mailing Address - City:SOLVAY
Mailing Address - State:NY
Mailing Address - Zip Code:13209
Mailing Address - Country:US
Mailing Address - Phone:631-903-9235
Mailing Address - Fax:
Practice Address - Street 1:304 S SALINA ST APT 1C
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-1634
Practice Address - Country:US
Practice Address - Phone:631-903-9235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
117644-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical