Provider Demographics
NPI:1598117376
Name:TINOCO, JENNY CECILIA (MS ED)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:CECILIA
Last Name:TINOCO
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8904 34TH AVE
Mailing Address - Street 2:APT. 6R
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-3562
Mailing Address - Country:US
Mailing Address - Phone:347-536-4242
Mailing Address - Fax:
Practice Address - Street 1:8904 34TH AVE
Practice Address - Street 2:APT. 6R
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-3562
Practice Address - Country:US
Practice Address - Phone:347-536-4242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-06
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1018228161174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist