Provider Demographics
NPI:1548590029
Name:KALBFELL, JENNIFER DZIALGA
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:DZIALGA
Last Name:KALBFELL
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 1:3235 LINCOLN DR
Mailing Address - Street 2:
Mailing Address - City:MOHEGAN LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:10547-1677
Mailing Address - Country:US
Mailing Address - Phone:914-819-3916
Mailing Address - Fax:
Practice Address - Street 1:3235 LINCOLN DR
Practice Address - Street 2:
Practice Address - City:MOHEGAN LAKE
Practice Address - State:NY
Practice Address - Zip Code:10547-1677
Practice Address - Country:US
Practice Address - Phone:914-819-3916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-06
Last Update Date:2010-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004911-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist