Provider Demographics
NPI:1447610985
Name:MIONE, JENNA
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:MIONE
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 1:374 ARBUCKLE AVE
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-1304
Mailing Address - Country:US
Mailing Address - Phone:516-503-4023
Mailing Address - Fax:
Practice Address - Street 1:374 ARBUCKLE AVE
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-1304
Practice Address - Country:US
Practice Address - Phone:516-503-4023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-25
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency