Provider Demographics
NPI:1609356526
Name:UPDYKE, JENNIFER (RDMS RVT RDCS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:UPDYKE
Suffix:
Gender:F
Credentials:RDMS RVT RDCS
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:EMERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 236
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:NY
Mailing Address - Zip Code:14806-0236
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12 MARTIN ST
Practice Address - Street 2:
Practice Address - City:WELLSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14895
Practice Address - Country:US
Practice Address - Phone:585-593-6069
Practice Address - Fax:585-219-5735
Is Sole Proprietor?:No
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471S1302XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistSonography