Provider Demographics
NPI:1598284945
Name:FRANCIS, JENICE
Entity Type:Individual
Prefix:MRS
First Name:JENICE
Middle Name:
Last Name:FRANCIS
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 1:196 E 35TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-3904
Mailing Address - Country:US
Mailing Address - Phone:347-241-1886
Mailing Address - Fax:
Practice Address - Street 1:5635 KINGS HWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-5413
Practice Address - Country:US
Practice Address - Phone:347-205-1807
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-18
Last Update Date:2020-11-20
Deactivation Date:2017-12-30
Deactivation Code:
Reactivation Date:2019-11-13
Provider Licenses
StateLicense IDTaxonomies
NY0064221224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant