Provider Demographics
NPI:1467113381
Name:FRANK, JENNA G
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:G
Last Name:FRANK
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 1:1380 LAWN AVE
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12306-2733
Mailing Address - Country:US
Mailing Address - Phone:518-588-1473
Mailing Address - Fax:
Practice Address - Street 1:32 COHOES RD
Practice Address - Street 2:
Practice Address - City:WATERVLIET
Practice Address - State:NY
Practice Address - Zip Code:12189-1811
Practice Address - Country:US
Practice Address - Phone:518-328-0430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist