Provider Demographics
NPI:1417494352
Name:JENNYB LMT LLC
Entity Type:Organization
Organization Name:JENNYB LMT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:K
Authorized Official - Last Name:BAKONYI
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:845-649-7032
Mailing Address - Street 1:831 ROUTE 211 E
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-1443
Mailing Address - Country:US
Mailing Address - Phone:845-673-5328
Mailing Address - Fax:
Practice Address - Street 1:831 ROUTE 211 E
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10941-1443
Practice Address - Country:US
Practice Address - Phone:845-673-5328
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-31
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019872225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty