Provider Demographics
NPI:1629639083
Name:WHEATON, JENIFER R (MSED)
Entity Type:Individual
Prefix:MS
First Name:JENIFER
Middle Name:R
Last Name:WHEATON
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:MS
Other - First Name:JENIFER
Other - Middle Name:R
Other - Last Name:GREENO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 SCHOOLMASTER CIR
Mailing Address - Street 2:
Mailing Address - City:FAIRPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14450-8433
Mailing Address - Country:US
Mailing Address - Phone:585-739-4716
Mailing Address - Fax:
Practice Address - Street 1:590 FISHERS STATION DR STE 130
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564-9744
Practice Address - Country:US
Practice Address - Phone:585-924-7207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist