Provider Demographics
NPI:1437578564
Name:FELICI-WEST, JENNA (MD)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:FELICI-WEST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11249-3296
Mailing Address - Country:US
Mailing Address - Phone:464-450-7748
Mailing Address - Fax:718-481-2061
Practice Address - Street 1:134 N 4TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11249-3296
Practice Address - Country:US
Practice Address - Phone:646-450-7748
Practice Address - Fax:718-481-2061
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-16
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR67782084P0800X
IL036.1634222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry