Provider Demographics
NPI:1598101131
Name:BIRNS, JENNIFER L (MSED)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:BIRNS
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 OXFORD RD APT 16A
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-4321
Mailing Address - Country:US
Mailing Address - Phone:315-982-8343
Mailing Address - Fax:
Practice Address - Street 1:245 OXFORD RD APT 16A
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-4321
Practice Address - Country:US
Practice Address - Phone:315-982-8343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist