Provider Demographics
NPI:1649585233
Name:KACHNOWSKI, JENNIFER BRENNAN (PT)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:BRENNAN
Last Name:KACHNOWSKI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:JENNIFER
Other - Middle Name:
Other - Last Name:BRENNAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:127 S BROADWAY
Mailing Address - Street 2:ST JOSEPH'S MEDICAL CENTER
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-4006
Mailing Address - Country:US
Mailing Address - Phone:914-378-7573
Mailing Address - Fax:
Practice Address - Street 1:127 S BROADWAY
Practice Address - Street 2:ST JOSEPH'S MEDICAL CENTER
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-4006
Practice Address - Country:US
Practice Address - Phone:914-378-7573
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-09
Last Update Date:2014-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011626-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist