Provider Demographics
NPI:1629319744
Name:BINGEL, JEANNETTE G
Entity Type:Individual
Prefix:MRS
First Name:JEANNETTE
Middle Name:G
Last Name:BINGEL
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:JEANNETTE
Other - Middle Name:G
Other - Last Name:LINNEY-BINGEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1189 RT. 374
Mailing Address - Street 2:
Mailing Address - City:DANNEMORA
Mailing Address - State:NY
Mailing Address - Zip Code:12929
Mailing Address - Country:US
Mailing Address - Phone:518-492-7366
Mailing Address - Fax:
Practice Address - Street 1:1189 RT. 374 COOK ST.
Practice Address - Street 2:
Practice Address - City:DANNEMORA
Practice Address - State:NY
Practice Address - Zip Code:12929
Practice Address - Country:US
Practice Address - Phone:518-492-7366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-14
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY650758051174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist