Provider Demographics
NPI:1659397032
Name:KITCHIN, JENNIFER S (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:S
Last Name:KITCHIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:440 MAMARONECK AVE
Mailing Address - Street 2:412
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-2418
Mailing Address - Country:US
Mailing Address - Phone:914-777-1799
Mailing Address - Fax:914-777-1899
Practice Address - Street 1:440 MAMARONECK AVE
Practice Address - Street 2:412
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-2418
Practice Address - Country:US
Practice Address - Phone:914-777-1799
Practice Address - Fax:914-777-1899
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2119391207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH47772Medicare UPIN
NY2K4381Medicare ID - Type Unspecified